Clinical Case on Leukoformula

Howell-Jolly Bodies & Binucleated Normoblasts in Blood Smear

Tue, 02 Jun 2026 09:00:00 +0300

Newborn infant.

Peripheral blood. Erythrocyte with a Howell-Jolly body (photo 1) and a binucleated normoblast with a Howell-Jolly body (photo 2).

🙏 The publication was kindly provided by Ekaterina Nozdrina, Omsk.

Diffuse Large B-Cell Lymphoma in Lymph Node Imprint

Tue, 19 May 2026 10:00:02 +0300

Imprint smear of a cervical lymph node from a 78-year-old woman.

Diagnosis based on HI and IHC results: diffuse large B-cell lymphoma (non-GCB, double expressor).

🙏 The publication was kindly provided by Elena Belyakova, Clinical Laboratory Diagnostics Physician, Pathologist, member of the FLM Hematology Committee, Department of Molecular Morphology, E.E. Eichwald Clinic, I.I. Mechnikov Northwestern State Medical University, St. Petersburg.

Urethral Smear Microscopy: Detecting Neisseria gonorrhoeae

Fri, 15 May 2026 08:00:01 +0300

Today’s patient is a 34-year-old male. Urethral smear. Neisseria gonorrhoeae (gonorrhea) was detected, intracellular Gram-negative diplococci. They typically appear as a “swarm of bees” in a male smear.

Acute Myeloid Leukemia Without Maturation: Blast Morphology

Wed, 13 May 2026 18:00:00 +0300

There is a pronounced recurrence in the arrangement of blast cells in a patient with acute myeloid leukemia without maturation.

🔬 Source: from the archive of Brazilian hematology specialist Marcio Melo

Bone Marrow Erythroid Lineage in Multiple Myeloma

Mon, 11 May 2026 08:00:00 +0300

Patient, 71 years old, diagnosed with multiple myeloma.

Complete blood count:

RBC 3.6×10^12/L

HGB 128 g/L

WBC 4.0 g/L

PLT 210×10^9/L

ESR 18 mm/hour.

In the control bone marrow aspirate, after a course of treatment, the erythroid lineage of hematopoiesis is expanded to 47.5% (normal range 14.5-26.5). Binucleated erythrokaryocytes (photo 2, 3) and mitotic figures (photo 5) are observed.

Marginal Zone Lymphoma: Atypical Lymphocytes in Blood Smear

Sat, 02 May 2026 08:00:01 +0300

B-cell MARGINAL ZONE LYMPHOMA (confirmed). In the patient’s CBC - moderate anemia and thrombocytopenia - RBC 3.65×10^{12/L
HGB 116 g/L,
PLT 100×10}9/L, Leukocytosis, RDW 73.22×10^9/L, with absolute lymphocytosis and neutropenia. In the photographs - ATYPICAL lymphocytes. Receiving treatment.

Myelogram in Suspected Lymphoproliferative Disease

Wed, 29 Apr 2026 08:00:00 +0300

PATIENT is 22 years old. Sternal puncture was prescribed to rule out lymphoproliferative disease.

In peripheral blood - moderate leukocytosis, other parameters are normal.

In the BONE MARROW ASPIRATE, the number of lymphocytes is slightly increased - 22.6% (N 4.3-13.7%), plasma cells 0.6 (N 0.4 - 1.8).

Bone Marrow Erythroid Hyperplasia in Splenomegaly Case

Sat, 25 Apr 2026 08:00:00 +0300

SPLENOMEGALY in a 56-year-old PATIENT. Complete blood count without abnormalities: RBC 4.66×10^{12/L
HGB 142 g/L
WBC 3.43×10}9/L PLT 149 ×10^9/L.

In the bone marrow aspirate, the granulocytic lineage is relatively narrowed (35.4%), lymphocytes are 13.5% (normal 4.3-13.7%), and erythrocaryocyte proliferation is significantly increased (45.0%). Binucleated erythrocaryocytes are observed. Megakaryocytes show preserved functional capacity.

Chronic Lymphocytic Leukemia: A Diagnostic Case Study

Wed, 22 Apr 2026 09:00:01 +0300

The patient was admitted for further examination and diagnosis.

He considers himself ill for about a month, when he began to experience fatigue, tiredness, and severe sweating, but continued to work and did not seek medical attention. He began to be examined in early April 2026, with leukocytosis up to 500x10*9/L in the complete blood count, lymphocytosis of 98%, total spleen area of 98 sq cm on abdominal ultrasound, abdominal lymphadenopathy up to 3 cm, and enlargement of submandibular, cervical, supraclavicular, axillary, iliac, and inguinal lymph nodes up to 2-3 cm.

Acute Myeloblastic Leukemia Without Maturation (FAB M1)

Tue, 21 Apr 2026 18:00:00 +0300

A patient with suspected acute leukemia. A complete blood count was performed, and the diagnosis was confirmed.

Marked leukocytosis was noted, with more than 90 percent of cells being myeloblasts. The picture corresponds to acute myeloblastic leukemia without maturation, variant 1 according to the French-American-British classification.

Babesiosis (Piroplasmosis): Detecting Babesia in Blood Smears

Wed, 15 Apr 2026 09:00:01 +0300

Babesia in dog blood. Microscopic examination of Romanowsky-Giemsa stained dog blood smears revealed intraerythrocytic pear-shaped parasites characteristic of Babesia or Piroplasma, which cause the disease piroplasmosis. In dogs, the pathogen enters the body through the bite of an infected tick.

Blasts in Peripheral Blood Smear with Pancytopenia

Tue, 14 Apr 2026 09:00:01 +0300

Blasts🔬

A patient was admitted to the emergency department. Complete blood count results: HGB -55; PLT- 41; WBC- 2.1. When counting the differential white blood cell count, 19% blasts were found!

Secondary Erythremia: Howell-Jolly Bodies in Blood Smear

Sat, 11 Apr 2026 08:00:00 +0300

🩸 CBC. Male. Secondary erythremia. Howell-Jolly bodies are present in erythrocytes.

🙏 Materials for publication were kindly provided by biologist of the Clinical Diagnostic Laboratory Yulia Guseva, Belorechenskaya Central District Hospital.

Acute Lymphoblastic Leukemia: Cytochemistry and Blast Morphology

Fri, 10 Apr 2026 10:00:01 +0300

TRILINEAGE cytopenia in a 75-year-old patient. Bone marrow aspirate shows total blast infiltration. The cytoplasm is basophilic with vacuolization. Myeloperoxidase reaction in blasts is negative. PAS reaction is positive in granular form. The morphocytochemical characteristics correspond to lymphoid lineage – a picture of acute lymphoblastic leukemia.

Blasts in Peripheral Blood in Acute Leukemia

Wed, 08 Apr 2026 11:00:00 +0300

BLASTS.

Peripheral blood of a patient with acute leukemia.

🙏 The publication was kindly provided by the clinical diagnostic laboratory physician Nana Novikova, CHUZ “Clinical Hospital” RZHD-Meditsina, Smolensk.

Opisthorchis Eggs in Bile: A Clinical Case Study

Fri, 03 Apr 2026 09:00:01 +0300

A patient from the gastroenterology department. History of epigastric pain since 2022. Complaints of pain in the left hypochondrium, discomfort and pain in the epigastrium, abdominal bloating.

Duodenal intubation.

Giant Platelet in a Peripheral Blood Smear

Wed, 01 Apr 2026 11:00:00 +0300

Giant platelet in peripheral blood of a cat, x1000 magnification Analysis for manual platelet count, smear prepared from a sodium citrate tube. Patient: mixed breed, 12 years old. Romanowsky-Giemsa staining.

Acute Leukemia in a Rat: Blast Morphology in Blood Smear

Tue, 31 Mar 2026 09:00:00 +0300

Peripheral blood of a rat. Patient: 1 year old.

Total white blood cell count: 258 thousand/µL

Romanowsky-Giemsa stain, magnification x1000

🙏 Publication kindly provided by hematologist of the VETLAB veterinary laboratory network Amira Kuznetsova, Moscow

Leukemization of Lymphoma: Atypical Lymphocytes in Blood Smear

Wed, 25 Mar 2026 09:00:01 +0300

A 54-year-old patient from the hematology department, diagnosed with lymphoma.

The complete blood count shows severe anemia, anisocytosis and poikilocytosis of erythrocytes; leukocytosis with lymphocytosis, predominantly represented by abnormal lymphocytes (blasts?), with irregular nuclear shapes, indistinct nucleoli, finely dispersed chromatin, some with vacuolated cytoplasm.

Trichomonads in Urine and Vaginal Discharge of a Pregnant Woman

Mon, 02 Mar 2026 10:05:55 +0300

The week started with trichomonads. A 30-year-old woman, 38-39 weeks pregnant.

She was admitted with complaints of ear pain, purulent discharge, and a body temperature increase to 38 degrees. During examination, flagellated protozoa were found in her Nechiporenko urine test. Trichomonads and Candida fungal mycelium were detected in the vaginal discharge. A large number of leukocytes were also present.

Acute Leukemia: Blast Morphology in Complete Blood Count

Mon, 23 Feb 2026 09:00:01 +0300

Acute leukemia in a patient who presented with complaints of epistaxis and general weakness. Age 21 years. Blastosis. The last medical examination was in 2025, and CBC parameters were normal.

Dysgranulocytopoiesis in Blood Smear: Suspected Myelodysplastic Syndrome

Wed, 18 Feb 2026 18:30:00 +0300

A 75-year-old patient reports severe fatigue and weakness for about a month. He has not seen a therapist; his medical history only includes inpatient treatment for surgery (hernia repair).

Bacteremia in Peripheral Blood Smear in Sepsis

Wed, 18 Feb 2026 08:00:00 +0300

Patient from the emergency department. CBC: leukocytes - 2.02 (4.0-9.010^9/L), erythrocytes - 4.44 (3.8-5.710^{12/L), hemoglobin - 142 (117-173 g/L), platelets - 18 (150-400*10}9/L).

Intracellular and extracellular bacteria were found during blood smear microscopy. Procalcitonin - 84.6 (< 0.5 ng/mL).

Plasma Cells in Bone Marrow in Multiple Myeloma

Mon, 09 Feb 2026 08:00:01 +0300

The patient was referred for a consultation with a hematologist due to anemia and leukocytosis. Bone marrow was taken, in which the number of plasma cells was increased. At the patient’s next appointment, hospitalization will likely be offered for further examination and treatment of the disease. At this stage, morphologically, multiple myeloma can be suspected.

Trichomonads in Urine of an Adolescent Girl: A Case Study

Mon, 09 Feb 2026 08:00:00 +0300

Trichomonads were first detected in the urine of a 15-year-old girl who denied sexual relations. Confirmed in a smear.

Unfortunately, there is no video of the urine microscopy.

Amorphous Urates in Urine Sediment: Laboratory Diagnostics

Sat, 07 Feb 2026 08:00:01 +0300

Acidic urine sediment with pH 5.5

Visually, the urine looks like carrot juice - cloudy with an orange tint; after centrifugation, a bright pink sediment is observed. Microscopy reveals amorphous urates throughout the field of view, with occasional squamous epithelial cells.

Opisthorchiasis: Diagnosis and Eosinophilia in Blood Tests

Wed, 28 Jan 2026 09:00:01 +0300

A patient from the gastroenterology department after Biltricide therapy. Eosinophils 11% (historically up to 30%). Duodenal intubation. Adult Opisthorchis worms and eggs were found.

🙏 The publication was kindly provided by Ekaterina Nozdrina, Omsk.

Acute Leukemia in a Child: Blastemia and Hyperleukocytosis

Wed, 28 Jan 2026 09:00:00 +0300

A child was admitted to the emergency department of a hospital. A 14-year-old girl. Leukocytes - 172. Platelets - 84. Hemoglobin - 111. Blasts - 95%. The child was transferred to the oncohematology department of another institution.

Waxy Casts in Urine Sediment Microscopy: Morphology & Diagnosis

Fri, 26 Dec 2025 11:00:25 +0300

Patient from the Department of Nephrology and Hemodialysis. Urine sediment microscopy. Waxy casts. Proteinuria 3.0 g/L.

Waxy casts are dense, homogeneous, wax-candle-like fragments, clearly contoured, straight and convoluted, short and long cylindrical formations. The casts may have cracks and bay-like indentations along their contour. Wide waxy casts form due to the stasis of hyaline and granular casts in dilated distal tubules and collecting ducts of the kidneys. These casts are called terminal casts.

Megaloblasts and Dyserythropoiesis in Anemia During Pregnancy

Fri, 26 Dec 2025 10:00:01 +0300

🩸 A 35-year-old woman, 24 weeks pregnant. Hemoglobin 75 g/L in blood test. Bone marrow aspirate images show dyserythropoiesis.

✅ Megaloblasts, cytoplasmic bridges, and various mitotic figures are present.