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Test ID: Peripheral Smear
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Peripheral Smear
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Useful For
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Examination of a peripheral smear is a powerful diagnostic test that can help in the diagnosis/ differential diagnosis of various benign and malignant hematological disorders and other systemic non-hematological conditions. In addition it is usedl for the detection of hemoparasites & microorganisms.
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Method name and description
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Microscopic examination of thin blood smear stained with Romanowsky stain. Comprehensive morphologic assessment of the three cell lines (RBCs, WBC and Platelets) with verification of the automated cell count, document clinically significant morphologic abnormalities, detection of abnormal circulating cells (i.e: blasts, lymphoma cells or non-hemopoietic cells).
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Clinical information
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Under normal conditions, the morphology and proportion of each blood cell type is fairly consistent in corresponding age groups. The morphology and proportion of each blood cell type may change in various hematologic diseases. The Peripheral smear (PS) is helpful in revealing the changes in morphology or proportion of each cell type in the peripheral blood, thus helping in the detection and diagnosis of various diseases or reactive conditions. Review of the peripheral smear is not required in all patients with a hematological disorder. Certain straightforward conditions such as iron deficiency anemia can be easily diagnosed on the basis of clinical information and basic laboratory data (eg, mean corpuscular volume [MCV], serum ferritin). However, there are a number of settings in which interpretation of the peripheral smear is especially important.
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Specimen type / Specimen volume / Specimen container
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Whole blood. Smears spread from EDTA (may be part of the CBC)
Container/Tube: EDTA.
Specimen Volume: 3-4 ml.
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Collection instructions / Special Precautions / Timing of collection
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Smears must be prepared within maximum 3-4 hours after blood collection.
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Relevant clinical information to be provided
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- Patient/family history of hemoglobinopathies, other hereditary anemia, G6PD deficiency
- Presence of lymphadenopathies, hepatomegaly, splenomegaly, skin lesions, etc.
- Recent history of blood transfusion
- History of medications that might affect blood cells count/morphology including chemotherapeutic drugs
- Previous history of hematologic or non-hematologic neoplasms
- Patients'/family history of bleeding disorders, purpura, ecchymotic patches, etc.
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Storage and transport instructions
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Transport the specimen at ambient temperature.
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Specimen Rejection Criteria
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Insufficient quantity of blood (<1ml in macrotubes & <0.5ml in microtubes)
Errors in patient identification.
Delayed (old) specimen.
Clotted specimen/hemolyzed sample.
Wrong/unlabeled collection container.
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Biological reference intervals and clinical decision values
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Factors affecting test performance and result interpretation
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Aged specimen, inproper transport/storage condition, Excess EDTA effect (collection of small quantity of blood).
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Turnaround time / Days and times test performed / Specimen retention time
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2 working days
Test is performed daily, 24/7
Normal slides are retained for 1 month. Abnormal cases are retained for longer time according to space availability.
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