MTCLS Bilal Masood

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MTCLS Bilal Masood Lab Science Pro!🧬🧑‍🔬 Specialized in Hematology.

Expert insights on Anemias, Leukemias, Lymphomas & other Hematological Disorders👨‍⚕️ Learn Hematology Through Real Microscope & Mindray's Automated Morphology🔬🔍

The peripheral smear of Plasmodium falciparum patient reveals small, delicate ring forms with double chromatin dots, oft...
11/07/2026

The peripheral smear of Plasmodium falciparum patient reveals small, delicate ring forms with double chromatin dots, often seen at the periphery of RBCs, along with multiple parasites infecting a single RBC. RBC size remains normal and no other developmental stages are present. These findings are characteristic of Plasmodium falciparum infection, which is clinically the most severe form of malaria.

The differentiation and maturation stages of granulocytic cells:Myeloblast → Promyelocytes → Myelocytes → Metamyelocyte ...
30/06/2026

The differentiation and maturation stages of granulocytic cells:

Myeloblast → Promyelocytes → Myelocytes → Metamyelocyte → Band nuclei stabment → Segmented neutrophils, with key features for each stage.

Myeloproliferative Hypereosinophilic Syndrome (M-HES)🫟: Marked eosinophilia with numerous eosinophils showing dysplastic...
29/06/2026

Myeloproliferative Hypereosinophilic Syndrome (M-HES)🫟: Marked eosinophilia with numerous eosinophils showing dysplastic changes, including nuclear hypersegmentation, irregular nuclear lobulation, and abnormal morphology. These features indicate a myeloproliferative disorder (Myeloproliferative Hypereosinophilic Syndrome [M-HES]/Eosinophilic Leukemia) in which the bone marrow produces excessive numbers of abnormal eosinophils.

Blood Clotting Process (Hemostasis):1. Vascular Spasm - Injury causes immediate constriction of the blood vessel to redu...
29/06/2026

Blood Clotting Process (Hemostasis):
1. Vascular Spasm - Injury causes immediate constriction of the blood vessel to reduce blood loss.

2. Platelet Plug Formation - Platelets bind to collagen. Platelet aggregation forms temporary plug.

3. Coagulation Cascade - Clotting factors activate. Prothrombin → Thrombin, Fibrinogen → Fibrin, needs Ca²⁺

4. Fibrin Mesh Formation- Fibrin forms a strong mesh that stabilizes the platelet plug.

5. Clot Retraction & Healing - Clot contracts and tissue healing begins.

Primary vs Secondary Hemostasis:
Primary = Platelet Plug Formation
Secondary = Fibrin Stabilization

Acute Promyelocytic Leukemia🫟: Peripheral film reveals abnormal promyelocytes with the characteristic of binucleated for...
27/06/2026

Acute Promyelocytic Leukemia🫟: Peripheral film reveals abnormal promyelocytes with the characteristic of binucleated forms (APML).

Palsmoidium falciparum🫟: RBCs infected with ring forms/trophozoites, schizonts, and crescent-shaped gametocytes of Plasm...
26/06/2026

Palsmoidium falciparum🫟: RBCs infected with ring forms/trophozoites, schizonts, and crescent-shaped gametocytes of Plasmodium falciparum. Multiple rings per RBC noted.

Rings/Trophozoites:
• Vivax = Large, thick ring in enlarged RBC with Schüffner’s dots, 1 ring/RBC.
• Falciparum = Small, thin, delicate ring in normal RBC, no dots, multiple rings/RBC common.

Schizonts:
• Vivax= Big, fills enlarged RBC, 12-24 loose merozoites + prominent Schüffner’s dots.
• Falciparum = Rare in blood, 8-24 tight merozoites, RBC normal size.

Gametocytes:
• Vivax = Round/oval, fills enlarged RBC. • Falciparum = Crescent/banana shaped in RBC.

Plasmodium Vivax🫟: Early trophozoites, schizonts, and gametocytes of Plasmodium vivax1) Early trophozoites (Young/ring f...
25/06/2026

Plasmodium Vivax🫟: Early trophozoites, schizonts, and gametocytes of Plasmodium vivax
1) Early trophozoites (Young/ring forms of malaria parasite)
2) Schizonts (Mature forms that will burst RBC and release more parasites, Contains 12-24 merozoites arranged like a bunch of grapes)
3) Gametocytes (Round/oval and large. They almost fill the enlarged RBC. Sexual forms that can infect mosquitoes, can spread to others)

Identify the cellsA) Both are blasts B) Both are Prolymphocyte C) A is Blast, B is Prolymphocyte
25/06/2026

Identify the cells
A) Both are blasts
B) Both are Prolymphocyte
C) A is Blast, B is Prolymphocyte

Diagnosed APML confirmed by PML-RARA fusion gene from t(15;17) translocation. Peripheral smear reveals 37% abnormal prom...
24/06/2026

Diagnosed APML confirmed by PML-RARA fusion gene from t(15;17) translocation. Peripheral smear reveals 37% abnormal promyelocytes, 18% blasts. Anemia with thrombocytopenia. Prolonged PT & APTT with low fibrinogen.

Additional Features of APML Beyond This Case
(General findings commonly observed in APML patients):

1. Morphology: Hypergranular abnormal promyelocytes with bilobed/kidney-shaped nuclei. Auer rods + fa**ot cells (bundles of Auer rods)

2. Schistocytes: Present due to DIC-related microangiopathic hemolysis.

3. Elevated D-dimer: With decreased fibrinogen confirms DIC pattern.

4. WBC count: Variable - can be pancytopenic or leukocytic. Hyperleukocytosis increases bleeding risk.

PML-RARA:
Fusion gene diagnostic for APML, formed by t(15;17)(q24;q21) translocation where the PML gene on chromosome 15q24 joins with the RARA gene on chromosome 17q21. Normal RARA protein regulates myeloid cell differentiation through retinoic acid signaling, but the PML-RARA fusion protein blocks promyelocytes from maturing and prevents apoptosis, causing accumulation of abnormal hypergranular promyelocytes in bone marrow and blood. It is confirmed by karyotype, FISH, or RT-PCR, with RT-PCR also used to monitor minimal residual disease during therapy. ATRA treatment targets this fusion by binding RARA and reversing the differentiation block.

Platelet Clumps (EDTA-Induced Pseudothrombocytopenia):Platelet clumping caused by EDTA. Produces a falsely low platelet ...
19/06/2026

Platelet Clumps (EDTA-Induced Pseudothrombocytopenia):
Platelet clumping caused by EDTA.
Produces a falsely low platelet count pseudothrombocytopenia.
Peripheral smear shows platelet aggregates/clumps. Not associated with true thrombocytopenia.
Confirm by repeating CBC in a sodium citrate tube, where the platelet count is usually normal.

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