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Module HEME-21 · Version 1.0

Chromatin, Cytoplasmic Inclusions, and Findings That Require Escalation

Use observable leukocyte morphology, CBC correlation, and local policy to describe high-concern findings without forcing an image-only diagnosis.

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Who this module is for

Medical laboratory scientists and hematology personnel performing peripheral-smear review after HEME-04 and HEME-20.

Learning objectives

  • Describe chromatin, nucleoli, nuclear contour, granulation, inclusions, and nuclear-cytoplasmic maturation.
  • Apply text-based criteria to describe Auer rods or rod-like cytoplasmic inclusions, dysgranulopoietic features, morula-like material, and MYH9-like patterns without image-only classification.
  • Separate confident description from provisional classification and urgent escalation.

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. 42 CFR §493.1252, Standard: Test systems, equipment, instruments, reagents, materials, and supplies. Federal regulation, United States.

    Source note · federal regulation

  2. 2. 42 CFR §493.1291, Standard: Test report. Federal regulation, United States.

    Source note · federal regulation

  3. 3. Clinical and Laboratory Standards Institute. H20, Reference Leukocyte Differential Count (Proportional) and Evaluation of Instrumental Methods, 3rd ed.

    Source note · consensus standard

  4. 4. 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. doi:10.1111/ijlh.12327.

    Source note · consensus standard

  5. 5. Khoury JD, Solary E, Abla O, et al. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Myeloid and Histiocytic/Dendritic Neoplasms. Leukemia. 2022;36:1703-1719. doi:10.1038/s41375-022-01613-1.

    Source note · professional society guidance

  6. 6. Arber DA, Orazi A, Hasserjian RP, et al. International Consensus Classification of Myeloid Neoplasms and Acute Leukemias: integrating morphologic, clinical, and genomic data. Blood. 2022;140:1200-1228. doi:10.1182/blood.2022015850.

    Source note · professional society guidance

  7. 7. Invernizzi R. Images from the Haematologica Atlas of Hematologic Cytology: dysgranulopoiesis. Haematologica. 2021;106:1229. doi:10.3324/haematol.2021.278517.

    Source note · peer-reviewed literature

  8. 8. Centers for Disease Control and Prevention. Clinical Testing and Diagnosis for Ehrlichiosis. Updated 2024-05-15.

    Source note · federal guidance

  9. 9. Savoia A, Pecci A. MYH9-Related Disease. GeneReviews®, University of Washington, Seattle. Updated 2021-02-18.

    Source note · professional society guidance

  10. 10. Sanz MA, Fenaux P, Tallman MS, et al. Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet. Blood. 2019;133:1630-1643. doi:10.1182/blood-2019-01-894980.

    Source note · professional society guidance

  11. 11. Current laboratory-controlled peripheral-smear review, critical-result communication, image-retention, and escalation procedures. Local document-control system.

    Source note · laboratory reference

  12. 12. College of American Pathologists. All Common Checklist, COM.30000 Critical Result Notification (Phase II). CAP Accreditation Program, 12.09.2025 edition.

    Source note · accreditation standard

  13. 13. College of American Pathologists. All Common Checklist, COM.30100 Critical Result Read-Back (Phase I). CAP Accreditation Program, 12.09.2025 edition.

    Source note · accreditation standard