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La Gioia A, Fumi M, Fiorini F, Bombara M, La Gioia N, Pancione Y, Sale S, Fiorini M, Rocco V. Mindray BC-6800 haematological analyser: 3D-DIFF scattergram usefulness in infectious mononucleosis diagnosis. Int J Lab Hematol 2021; 43:581-587. [PMID: 33891809 DOI: 10.1111/ijlh.13552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/29/2021] [Accepted: 04/02/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION 3D-DIFF scattergram of the Mindray BC-6800 haematological analyser shows morphological abnormalities and lymphocyte cluster splitting related to the presence of reactive lymphocytes. This study aims to assess whether these cytographic changes are useful in detecting both activated and apoptotic lymphocytes, leading to an improvement in the laboratory diagnostic process of infectious mononucleosis. METHODS Two hundred three samples with modified shape and doubled lymphocyte cluster of DIFF scattergram (study group) were divided into two different subgroups: with and, respectively, without serological evidence of ongoing IM. Activated and apoptotic cells in peripheral blood were counted by light microscopy or gating in the instrumental dot plots. Values of apoptotic cells counted by microscopy were compared with those resulting from gating. RESULTS Samples with both shape change and doubled lymphocyte cluster had serological profiles according to the diagnosis of ongoing infectious mononucleosis. Blood smears review was positive for reactive lymphocytes in all 112 samples (100%). An underestimation of apoptotic cell count by light microscopy compared with the gating in the instrumental scatterplot was also observed (96 out of 112, 85.7%). CONCLUSION The additional lymphocyte cluster was significantly associated with activated and apoptotic lymphocytes in samples with serology suggesting ongoing infectious mononucleosis. Considering the significance of clue for infectious mononucleosis assigned to the apoptotic lymphocytes, a specific flag such as "apoptotic cells?" could be associate with the related cluster. Such a flag could be used for dedicated rules for smears review, thus increasing infectious mononucleosis detection in laboratories that do not usually practise instrumental cytograms observation.
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Affiliation(s)
- Antonio La Gioia
- Docemus Onlus "Theoretical and Practical Training School for Improving Specialty Medicine", Torrevecchia Teatina, Italy
| | - Maurizio Fumi
- U.O. Patologia Clinica A.O.R.N. "G. Rummo", Benevento, Italy
| | - Fabiana Fiorini
- UOC Medicina di Laboratorio Azienda USL Toscana Nord Ovest, Pontedera, Italy
| | - Maria Bombara
- UOC Medicina di Laboratorio Azienda USL Toscana Nord Ovest, Livorno, Italy
| | - Nicola La Gioia
- Docemus Onlus "Theoretical and Practical Training School for Improving Specialty Medicine", Torrevecchia Teatina, Italy
| | - Ylenia Pancione
- U.O. Patologia Clinica A.O.R.N. "G. Rummo", Benevento, Italy
| | - Silvia Sale
- U.O. Patologia Clinica A.O.R.N. "G. Rummo", Benevento, Italy
| | - Marcello Fiorini
- UOC Medicina di Laboratorio Azienda USL Toscana Nord Ovest, Pontedera, Italy
| | - Vincenzo Rocco
- U.O. Patologia Clinica A.O.R.N. "G. Rummo", Benevento, Italy
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Sale S, Rocco V, Pancione Y, Carri DD, Fumi M, Bain BJ. A confusing "white cell count": Circulating micromegakaryocytes in post-thrombocythemia myelofibrosis. Am J Hematol 2019; 94:617-618. [PMID: 30549313 DOI: 10.1002/ajh.25377] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Silvia Sale
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera G. Rummo Benevento Italy
| | - Vincenzo Rocco
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera G. Rummo Benevento Italy
| | - Ylenia Pancione
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera G. Rummo Benevento Italy
| | - Daniele Delli Carri
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera G. Rummo Benevento Italy
| | - Maurizio Fumi
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera G. Rummo Benevento Italy
| | - Barbara J. Bain
- Department of Haematology, Centre for HaematologySt Mary's Hospital Campus of Imperial College London Faculty of Medicine, St Mary's Hospital London United Kingdom
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Di Matola T, Miele C, Coppola M, Fumi M, Pancione Y, Sale S, Atripaldi L, Rocco V. Utility of peripheral blood smear in rapid diagnosis of Pertussis. Int J Lab Hematol 2018; 41:e41-e42. [PMID: 30480363 DOI: 10.1111/ijlh.12947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 10/18/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Tiziana Di Matola
- A.O.R.N. Ospedale dei Colli, UOC Biochimica Clinica, Monaldi, Napoli, Italy
| | - Ciro Miele
- A.O.R.N. Ospedale dei Colli, UOC Biochimica Clinica, Monaldi, Napoli, Italy
| | - Maurizio Coppola
- A.O.R.N. Ospedale dei Colli, UOC Biochimica Clinica, Monaldi, Napoli, Italy
| | - Maurizio Fumi
- A.O.R.N. "G. Rummo" Benevento, U.O. Patologia Clinica, Benevento, Italy
| | - Ylenia Pancione
- A.O.R.N. "G. Rummo" Benevento, U.O. Patologia Clinica, Benevento, Italy
| | - Silvia Sale
- A.O.R.N. "G. Rummo" Benevento, U.O. Patologia Clinica, Benevento, Italy
| | - Luigi Atripaldi
- A.O.R.N. Ospedale dei Colli, UOC Biochimica Clinica, Monaldi, Napoli, Italy
| | - Vincenzo Rocco
- A.O.R.N. "G. Rummo" Benevento, U.O. Patologia Clinica, Benevento, Italy
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Rocco V, Castelli C, Fumi M, Mancini F, Pancione Y, Prisciandaro M, Sale S, Tanca D, Vagnoni D. The diagnostic use of ADVIA 2120i Siemens and an “APL criteria” can help to reduce the rate of early death in the APL. Int J Lab Hematol 2018; 41:124-132. [DOI: 10.1111/ijlh.12935] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 08/28/2018] [Accepted: 09/13/2018] [Indexed: 01/16/2023]
Affiliation(s)
- Vincenzo Rocco
- Clinical Patology Laboratory A.O.R.N. “G. Rummo” di Benevento Benevento Italy
| | - Christian Castelli
- Department of Laboratory Medicine EOLAB Ente Ospedaliero Cantonale Bellinzona Switzerland
| | - Maurizio Fumi
- Clinical Patology Laboratory A.O.R.N. “G. Rummo” di Benevento Benevento Italy
| | - Francesca Mancini
- Department of Cellular Biotechnologies and Hematology Sapienza University Rome Italy
| | - Ylenia Pancione
- Clinical Patology Laboratory A.O.R.N. “G. Rummo” di Benevento Benevento Italy
| | - Michele Prisciandaro
- Department of Molecular Medicine Policlinico Umberto I Sapienza University Rome Italy
| | - Silvia Sale
- Clinical Patology Laboratory A.O.R.N. “G. Rummo” di Benevento Benevento Italy
| | - Donatella Tanca
- Department of Laboratory Medicine Azienda Sanitaria Locale Regione Liguria Lavagna Italy
| | - Davide Vagnoni
- Department of Laboratory Medicine Civitanova Marche Italy
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La Gioia A, Fumi M, Fiorini F, Pezzati P, Balboni F, Bombara M, Marini A, Pancione Y, Solarino L, Marchese E, Sale S, Rocco V, Fiorini M. Short preheating at 41°C leads to a red blood cells count comparable to that in RET channel of Sysmex analysers in samples showing cold agglutination. J Clin Pathol 2018. [PMID: 29535214 DOI: 10.1136/jclinpath-2017-204954] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS The presence of cold agglutinin in blood samples can cause a spontaneous agglutination of red blood cells (RBCs) when low temperature occurs. This phenomenon causes a spurious lowering of RBC count on the automated haematological analysers that are detected by incongruous values (≥370 g/L) of the mean cellular haemoglobi concentration (MCHC). A preheating at 37°C can remove the RBC agglutination generally resulting in a reliable count. It has been reported that the same result can be reached by using the optical reticulocyte (RET) channel of Sysmex analysers where the RBC count is not influenced by the presence of cold agglutinin. This study aims to evaluate these data in a larger population, with regard to environmental conditions on Sysmex analysers. We have also evaluated the influence of different thermal pretreatments on the RBC count. METHODS This study was performed on 96 remnants of peripheral blood samples (48 with MCHC in normal range and 48 with MCHC>370 g/L) which have been analysed in different preanalytical conditions on the Sysmex analysers. RESULTS A preheating of samples at 41°C for 1 min leads to a reversibility of the cold agglutination comparable to the one observed in the RET channel and yields better results compared with 37°C for 2 hours. CONCLUSIONS None of described procedures assure the complete cold agglutination reversibility in every case. Consequently, since the haematological analysers not yet provide reliable parameters to confirm the complete resolution of agglutination, further verification of RBC count accuracy needs to be performed.
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Affiliation(s)
- Antonio La Gioia
- Docemus Onlus "Theoretical and Practical Training School for Improving Specialty Medicine", Torrevecchia Teatina, Italy
| | - Maurizio Fumi
- U.O. Patologia Clinica A.O.R.N. "G.Rummo", Benevento, Italy
| | - Fabiana Fiorini
- UOC Medicina di Laboratorio Azienda USL Toscana Nord Ovest, Pontedera, Italy
| | - Paola Pezzati
- Centro Regionale Controllo di Qualità AOU Careggi, Firenze, Italy
| | - Fiamma Balboni
- Laboratorio Analisi IFCA (Istituto Fiorentino di Cura ed Assistenza), Firenze, Italy
| | - Maria Bombara
- UOC Medicina di Laboratorio Azienda USL Toscana Nord Ovest, Livorno, Italy
| | - Alessandra Marini
- UOC Medicina di Laboratorio Azienda USL Toscana Nord Ovest, Versilia, Italy
| | | | - Leonardo Solarino
- UOC Laboratorio Analisi I - Policlinico Vittorio Emanuele, Azienda Universitaria Ospedaliera, Catania, Italy
| | - Elisa Marchese
- UOC Laboratorio Analisi I - Policlinico Vittorio Emanuele, Azienda Universitaria Ospedaliera, Catania, Italy
| | - Silvia Sale
- U.O. Patologia Clinica A.O.R.N. "G.Rummo", Benevento, Italy
| | - Vincenzo Rocco
- U.O. Patologia Clinica A.O.R.N. "G.Rummo", Benevento, Italy
| | - Marcello Fiorini
- UOC Medicina di Laboratorio Azienda USL Toscana Nord Ovest, Livorno, Italy
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Fumi M, Pancione Y, Sale S, Rocco V, Bain BJ. Botryoid nuclei resulting from cocaine abuse. Am J Hematol 2017; 92:1260-1261. [PMID: 28439943 DOI: 10.1002/ajh.24769] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 04/18/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Maurizio Fumi
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera G. Rummo; Benevento Italy
| | - Ylenia Pancione
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera G. Rummo; Benevento Italy
| | - Silvia Sale
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera G. Rummo; Benevento Italy
| | - Vincenzo Rocco
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera G. Rummo; Benevento Italy
| | - Barbara J. Bain
- Department of Haematology; Imperial College Healthcare NHS Trust and Centre for Haematology, St Mary's Hospital Campus of Imperial College London Faculty of Medicine, St Mary's Hospital; London W2 1NY United Kingdom
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La Gioia A, Fumi M, Pezzati P, Balboni F, Pancione Y, Rocco L, Sale S, Bombara M, Fiorini M, Fiorini F, Rocco V. Automatic wedge smears preparation may cause traumatic morphological changes in peripheral blood cells. J Clin Pathol 2017; 71:168-171. [DOI: 10.1136/jclinpath-2017-204580] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 07/12/2017] [Accepted: 07/19/2017] [Indexed: 11/03/2022]
Abstract
In recent years, several automated analysers that prepare and stain blood smears have been introduced in clinical laboratories. Despite the use of instrumental settings based on physical characteristic of individual samples, traumatic injuries of neutrophil and lymphocytes can be observed. Some samples present a very high percentage of damaged cells, allowing the speculation that a cellular susceptibility may enhance mechanical traumatism. These artefacts can puzzle morphological evaluation in both traditional and digitised microscopy; in addition, unskilled operators can be misled.
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La Gioia A, Fiorini F, Fumi M, Fiorini M, Pancione Y, Rocco L, Sale S, Bombara M, Rocco V. A prolonged microscopic observation improves detection of underpopulated cells in peripheral blood smears. Ann Hematol 2017; 96:1749-1754. [DOI: 10.1007/s00277-017-3073-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 07/17/2017] [Indexed: 10/19/2022]
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Sale S, Fumi M, Pancione Y, Parente D, Rocco V, Bain BJ. The fortuitous diagnosis of Burkitt lymphoma in a patient with chronic myelomonocytic leukemia. Am J Hematol 2016; 91:443. [PMID: 26800105 DOI: 10.1002/ajh.24297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 01/07/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Silvia Sale
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera G. Rummo, Benevento, Italy
| | - Maurizio Fumi
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera G. Rummo, Benevento, Italy
| | - Ylenia Pancione
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera G. Rummo, Benevento, Italy
| | | | - Vincenzo Rocco
- Dipartimento di Medicina di Laboratorio, Azienda Ospedaliera G. Rummo, Benevento, Italy
| | - Barbara J Bain
- Department of Haematology, Imperial College Healthcare NHS Trust and Centre for Haematology, St Mary's Hospital Campus of Imperial College London Faculty of Medicine, St Mary's Hospital, London, United Kingdom
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Affiliation(s)
- Ylenia Pancione
- Dipartimento di Medicina di Laboratorio; Azienda Ospedaliera G. Rummo; Benevento Italy
| | - Maurizio Fumi
- Dipartimento di Medicina di Laboratorio; Azienda Ospedaliera G. Rummo; Benevento Italy
| | - Silvia Sale
- Dipartimento di Medicina di Laboratorio; Azienda Ospedaliera G. Rummo; Benevento Italy
| | - Vincenzo Rocco
- Dipartimento di Medicina di Laboratorio; Azienda Ospedaliera G. Rummo; Benevento Italy
| | - Barbara J. Bain
- Department of Haematology, Imperial College Healthcare NHS Trust and Centre for Haematology; St Mary's Hospital Campus of Imperial College London Faculty of Medicine, St Mary's Hospital; Praed Street London W2 1NY UK
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Sale S, Carone AE, Fumi M, Pancione Y, Rocco V. Detection of Apoptotic Lymphocytes Through Sysmex XN-1000 As a Diagnostic Marker for Mononucleosis Syndrome. J Clin Lab Anal 2016; 30:779-93. [PMID: 27094572 DOI: 10.1002/jcla.21938] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 12/28/2015] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The infectious mononucleosis (IM) includes clue elements, apoptotic and atypical lymphocytes. In IM, the evaluation of dot plot provided by Sysmex XN-1000 analyzer revealed a stretched lymphocytic cluster, white cell differential channel (WDF), on cytogram. METHODS In this study, we analyzed 698 samples that include 39 IM, 76 chronic lymphoproliferative disorders, 25 nonclonal lymphocytosis, and 40 healthy donors. Five hundred eighteen samples with other diseases or interference were evaluated. The algorithm was validated on 40,000 files that were received from internal database of Sysmex-Dasit. RESULTS The analysis of flow cytometry standard (FCS) files in WDF channel and presumed apoptotic lymphocytes counts on side scatter/forward scatter (SSC/FSC) and SSC/SFL (where SFL is side fluorescence) dot plot revealed excellent correlation among apoptotic cells on peripheral blood smear (R(2) = 0.79 and 0.75). There was a variation of positional parameters in lymphocyte clusters WX, WY, and WZ. If WX-SSC > 500 and WY-SFL > 1,000 and WZ-FSC > 700, specificity equals to 99% and sensitivity equals to 100%. If nucleated red blood cell (NRBC) <0.03 × 10(3) /μl, specificity equals to 100%. In received files, positives were 1% adding the simultaneous presence of a percentage of events in the two gates relating to the apoptotic lymphocytes of 1.2% of WBC. CONCLUSION On Sysmex XN-1000, dot-plot observation allowed immediate detection of IM. Meanwhile, an algorithm based on the parameters on these plots can be calculated with excellent performance.
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Affiliation(s)
- Silvia Sale
- Clinical Pathology Laboratory, A.O.R.N. "G. Rummo,", Benevento, Italy
| | | | - Maurizio Fumi
- Clinical Pathology Laboratory, A.O.R.N. "G. Rummo,", Benevento, Italy
| | - Ylenia Pancione
- Clinical Pathology Laboratory, A.O.R.N. "G. Rummo,", Benevento, Italy
| | - Vincenzo Rocco
- Clinical Pathology Laboratory, A.O.R.N. "G. Rummo,", Benevento, Italy.
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Blasio E, Pellegrini C, Federico A, Rocco V, Fumi M, Pancione Y, Sale S, Liberti D. Coagulation support algorithm with rapid TEG and functional fibrinogen TEG in critical bleeding: more results and less time. Crit Care 2015. [PMCID: PMC4471096 DOI: 10.1186/cc14432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Fumi M, Martins D, Pancione Y, Sale S, Rocco V. Automated quantification of apoptosis in B-cell chronic lymphoproliferative disorders: a prognostic variable obtained with the Cell-Dyn Sapphire (Abbott) automated hematology analyzer. Int J Lab Hematol 2014; 36:628-35. [DOI: 10.1111/ijlh.12198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 11/13/2013] [Indexed: 11/28/2022]
Affiliation(s)
- M. Fumi
- Clinical Pathology Laboratory; A.O.R.N ‘G. Rummo’ di Benevento; Benevento Italy
| | - D. Martins
- Clinical Pathology Laboratory; A.O.R.N ‘G. Rummo’ di Benevento; Benevento Italy
| | - Y. Pancione
- Clinical Pathology Laboratory; A.O.R.N ‘G. Rummo’ di Benevento; Benevento Italy
| | - S. Sale
- Clinical Pathology Laboratory; A.O.R.N ‘G. Rummo’ di Benevento; Benevento Italy
| | - V. Rocco
- Clinical Pathology Laboratory; A.O.R.N ‘G. Rummo’ di Benevento; Benevento Italy
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