Preface x
Note to the reader xi
Acknowledgements xii
Abbreviations xv
1 Malaria – one swallow makes a summer 1
2 The significance of irregularly contracted cells and hemighosts in sickle cell disease 2
3 Striking dyserythropoiesis in sickle cell anemia following an aplastic crisis 3
4 A normal mean cell volume does not exclude a diagnosis of megaloblastic anemia 4
5 Prominent Howell–Jolly bodies when megaloblastic anemia develops in a hyposplenic patient 6
6 A ghostly presence – G6PD deficiency 7
7 G6PD deficiency in patients identified as female 8
8 The cause of sudden anemia revealed by the blood film 9
9 Choreo-acanthocytosis 10
10 Lead poisoning 12
11 Dysplastic neutrophils in an HIV-positive woman 14
12 Help with HELLP 15
13 Neutrophil dysplasia induced by granulocyte colony-stimulating factor 16
14 COVID-19 and acute kidney injury 17
15 Diagnosis of pyrimidine 5′nucleotidase deficiency suspected from a blood film 19
16 Bone marrow aspirate in Chédiak–Higashi syndrome 20
17 Phytosterolemia 21
18 Pseudo-Chédiak–Higashi inclusions together with Auer rods in acute myeloid leukemia 22
19 Botryoid nuclei resulting from cocaine abuse 23
20 Infantile pyknocytosis 25
21 Splenic rupture in cytomegalovirus infection 27
22 A new diagnosis of monoclonal B-cell lymphocytosis with cytoplasmic inclusions in a patient with COVID-19 29
23 Pseudoplatelets and apoptosis in Burkitt lymphoma 31
24 What is a promonocyte? 32
25 Persistent neonatal jaundice resulting from hereditary pyropoikilocytosis 34
26 Auer rods or McCrae rods? 36
27 Observation of Auer rods in crushed cells in acute promyelocytic leukemia 37
28 Alpha chain inclusions in peripheral blood erythroblasts and erythrocytes 39
29 Dyserythropoiesis in visceral leishmaniasis 41
30 Compound heterozygosity for hemoglobins S and D 42
31 Granular B lymphoblastic leukemia 43
32 Hyposplenism in adult T-cell leukemia/lymphoma 44
33 Voxelotor in sickle cell disease 45
34 The importance of a negative image 48
35 Seeing what isn’t there 49
36 A young woman with sudden onset of a severe coagulation abnormality 50
37 Immature Plasmodium falciparum gametocytes in bone marrow 51
38 Acute myeloid leukemia with myelodysplasia-related changes showing basophilic differentiation 52
39 Thiamine-responsive megaloblastic anemia in an Iraqi girl 53
40 Teardrop poikilocytes in metastatic carcinoma of the breast 54
41 A blood film that could have averted a splenectomy 55
42 Russell bodies and Mott cells 57
43 Dutcher bodies 59
44 Acute myeloid leukemia with inv(16)(p13.1q22) 61
45 Dysplastic macropolycytes in myelodysplasia-related acute myeloid leukemia 63
46 Diagnosis of cystinosis from a bone marrow aspirate 64
47 Emperipolesis in a patient receiving romiplostim 65
48 Mechanical hemolysis: a low mean cell volume does not always represent microcytosis 66
49 Transplant-associated thrombotic microangiopathy 67
50 Neuroblastoma in the bone marrow 69
51 Gray platelet syndrome 70
52 Diagnosis of systemic lupus erythematosus from a bone marrow aspirate 71
53 Diagnosis from a blood film following a dog bite 72
54 Interpreting a postpartum Kleihauer test 73
55 Dengue fever in returning travellers 74
56 Auer rod-like inclusions in multiple myeloma 76
57 Azurophilic granules in myeloma cells 77
58 Plasmodium knowlesi 78
59 The cytological features of NPM1-mutated acute myeloid leukemia 79
60 Irregularly contracted cells in Wilson disease 81
61 Pseudo-Pelger–Huët neutrophil morphology due to sodium valproate toxicity 82
62 The distinctive cytological features of T-cell prolymphocytic leukemia 83
63 Eosinophil morphology in the reactive eosinophilia of Hodgkin lymphoma 86
64 Malaria pigment 87
65 Salmonella colonies in a bone marrow film 88
66 Severe babesiosis due to Babesia divergens acquired in the UK 89
67 Congenital acute megakaryoblastic leukemia 91
68 Basophilic differentiation in transient abnormal myelopoiesis 92
69 Methylene blue-induced Heinz body hemolytic anemia in a premature neonate 93
70 Neutrophil vacuolation in acetominophen-induced acute liver failure 95
71 Howell–Jolly bodies in acute hemolytic anemia 96
72 The distinctive micromegakaryocytes of transformed chronic myeloid leukemia 97
73 Copper deficiency 98
74 Chronic neutrophilic leukemia 99
75 Neutrophilic leukemoid reaction in multiple myeloma 101
76 Persistent polyclonal B lymphocytosis 103
77 Non-hemopoietic cells in the blood and bone marrow 104
78 It’s a black day – metastatic melanoma in the bone marrow 105
79 Dehydrated hereditary stomatocytosis 106
80 Circulating lymphoma cells in intravascular large B-cell lymphoma 107
81 Unusual inclusions in hemoglobin H disease post-splenectomy 108
82 An unexpectedly bizarre blood film in hemoglobin H disease 109
83 Acute myeloid leukemia with a severe coagulopathy and t(8;16)(p11;p13) 111
84 Cold autoimmune hemolytic anemia secondary to atypical pneumonia 113
85 A confusing ‘white cell count’ – circulating micromegakaryocytes in post-thrombocythemia myelofibrosis 114
86 Diagnosis of follicular lymphoma from the peripheral blood 115
87 Transformation of follicular lymphoma 117
88 Cytology of systemic mastocytosis 118
89 Systemic mastocytosis – the importance of looking within bone marrow fragments 119
90 Schistocytosis is not always microangiopathic hemolytic anemia 120
91 Hemoglobin C disease 121
92 Hemoglobin St Mary’s 122
93 Congenital sideroblastic anemia in a female 123
94 A puzzling case of methemoglobinemia 125
95 Hodgkin lymphoma in a bone marrow aspirate 127
96 Giant proerythroblasts in pure red cell aplasia due to parvovirus B19 infection in a patient with rheumatoid arthritis 128
97 A myeloid neoplasm with FIP1L1::PDGFRA presenting as acute myeloid leukemia 129
98 Breast implant-associated anaplastic large cell lymphoma 131
99 Large granular lymphocytosis induced by dasatinib 132
100 The distinctive cytology and disease evolution of blastic plasmacytoid dendritic cell neoplasm 134
101 Platelet phagocytosis as a cause of pseudothrombocytopenia 136
Test yourself 137
Answers to test cases 145
Index 152