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Module HEME-04 · Version 1.0

Normal White Cells and the Differential

Identify normal leukocytes, count a representative manual differential, and reconcile it with an automated result using a flagged specimen.

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Who this module is for

Foundation-level medical laboratory learners who have completed CBC and smear basics and need a consistent approach to normal leukocyte morphology and manual differential review.

Learning objectives

  • Distinguish neutrophils, lymphocytes, monocytes, eosinophils, and basophils using multiple morphologic features.
  • Use a systematic battlement (stepwise) or serpentine (alternating) differential path that avoids recounting and edge bias.
  • Calculate relative and absolute counts and reconcile a manual differential with analyzer data.

How completion works

Mark every required section done and answer every knowledge check in those sections correctly. The final save completes the module automatically.

Sources

13 sources

  1. 1. Clinical and Laboratory Standards Institute. H20, Reference Leukocyte Differential Count (Proportional) and Evaluation of Instrumental Methods, 3rd ed. Wayne, PA: CLSI; 2026.

    Source note · consensus standard

  2. 2. Palmer L, Briggs C, McFadden S, et al. ICSH recommendations for the standardization of nomenclature and grading of peripheral blood cell morphological features. Int J Lab Hematol. 2015;37:287-303.

    Source note · consensus standard

  3. 3. Barnes PW, McFadden SL, Machin SJ, Simson E. Suggested criteria for action following automated CBC and WBC differential analysis. Lab Hematol. 2005;11(2):83-90.

    Source note · professional society guidance

  4. 4. Vergara-Lluri ME, et al. Significant variability in identification and reporting of band neutrophils. Arch Pathol Lab Med. 2024;148(6):666-.

    Source note · peer-reviewed literature

  5. 5. Rumke CL. Variability of results in differential cell counts on blood smears. Triangle. 1960;4:154-158.

    Source note · peer-reviewed literature

  6. 6. Rodak's Hematology and laboratory hematology teaching literature on battlement and serpentine manual differential scan paths and relative and absolute count formulas.

    Source note · peer-reviewed literature

  7. 7. Study of causes for poor leukocyte distribution in manual spreader-slide blood films. Am J Clin Pathol.

    Source note · peer-reviewed literature

  8. 8. Histology, White Blood Cell. StatPearls Publishing; updated 2024.

    Source note · peer-reviewed literature

  9. 9. Normal and Abnormal Complete Blood Count With Differential. StatPearls Publishing; updated 2024.

    Source note · peer-reviewed literature

  10. 10. Peer-reviewed case literature and review material describing reactive lymphocyte morphology in EBV and CMV infection.

    Source note · peer-reviewed literature

  11. 11. 42 CFR 493.941, Hematology, Electronic Code of Federal Regulations.

    Source note · federal regulation

  12. 12. 42 CFR 493.1451(b)(8)-(9), Standard; Technical supervisor responsibilities, Electronic Code of Federal Regulations.

    Source note · federal regulation

  13. 13. LatticeMLS module packet, HEME-04 research and production prompts, internal curriculum directive.

    Source note · manufacturer labeling