ABSTRACT
We report an unusual observation of Cryptococcal neoformans profiles engulfed by neutrophils on a routine peripheral blood smear examination in an HIV-negative young female patient who presented with perforation of large bowel following a pregnancy termination procedure by an untrained midwife.
Subject(s)
Abortion, Induced/adverse effects , Adult , Cryptococcosis/diagnosis , Cryptococcus neoformans/isolation & purification , Disseminated Intravascular Coagulation/etiology , Female , Humans , Intestinal Perforation/etiology , Neutrophils/microbiology , Peritonitis/etiology , Pregnancy , Sepsis/etiology , Uterine Perforation/etiologyABSTRACT
BACKGROUND & OBJECTIVE: A reliable and reproducible report from a laboratory needs internal quality control within the laboratory and participation in external proficiency testing programmes (EPTP). This study conducted at the Department of Haematology, All India Institute of Medical Sciences (AIIMS), New Delhi, which has been conducting an EPTP since 1992, was undertaken to assess the efficacy of this programme in improving the performance of participating laboratories in reporting test samples sent for Hb, total leucocyte count (TLC), reticulocyte count and assessment of peripheral blood smear (PBS). METHODS: The samples were prepared in our laboratory according to the International Standards Organization (ISO) guidelines. The performance of individual laboratories was assessed using robust Z score, which is an indicator of acceptability of the test result. RESULTS: An improvement in the overall percentage of laboratories with acceptable reports was seen during the study period. It has increased from 38,40,40 per cent in 1992 to 85, 90,94.7 per cent in 2006 for Hb, TLC, reticulocyte count, respectively. However, the results for peripheral smear assessment improved only marginally. INTERPRETATION & CONCLUSION: The external haematology proficiency testing programme run by our department for Hb, TLC, reticulocyte count, and peripheral blood smear assessment, has helped in improving the reporting standards of these parameters in Indian laboratories.
Subject(s)
Blood Chemical Analysis , Hematologic Tests/standards , Humans , India , Laboratories/standards , Quality Assurance, Health Care , Quality Control , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
Non-hematopoietic malignancies infiltrating bone marrow have always been a source of erroneous diagnosis. Among these, the small round cell tumors like neuroblastomas and rhabdomyosarcomas mimick the hematopoietic blasts. Several case reports of rhabdomyosarcoma mimicking acute leukemia, clinically and morphologically at presentation have been reported in the literature. To the best of our knowledge such an entity has not been reported in Indian literature. We report here one such case of alveolar rhabdomyosarcoma masquerading as acute leukemia. A thorough clinical examination with high degree of suspicion on bone marrow morphology and judicious use of appropriate immunohistochemistry markers will solve many of these cases.
Subject(s)
Adolescent , Ki-1 Antigen/analysis , Leukocyte Common Antigens/analysis , Bone Marrow/pathology , Desmin/analysis , Diagnosis, Differential , Humans , Immunohistochemistry , Male , MyoD Protein/analysis , Myogenin/analysis , Peroxidase/analysis , Phosphopyruvate Hydratase/analysis , Rhabdomyosarcoma, Alveolar/chemistry , Biomarkers, Tumor/analysisABSTRACT
A 1 1/2-year-old boy presented with fever, anemia, petechial rash and hepatosplenomegaly. Bone marrow examination showed two morphologically distinct blasts (small and large) which were confirmed on immunophenotyping to be of T-lymphoid and megakaryocytic lineages respectively. Patient was refractory to therapy. This is a rare combination of bi-lineal leukemia in a child.