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Module HEME-22 · Version 1.0

Flagged Neutrophilia: A Bounded CBC and Smear Workflow

Use one locally governed workflow to verify a flagged neutrophilia result, calculate and compare the local ANC, resolve the immature-granulocyte flag on a Wright-Giemsa smear, and route rather than diagnose.

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Who this module is for

Medical laboratory scientists and hematology staff performing CBC differential and peripheral-smear review under a locally validated procedure.

Learning objectives

  • Apply the same verification-to-routing workflow to a flagged neutrophilia result before interpreting its differential.
  • Calculate ANC from the reported neutrophil and band fractions and compare it with the locally verified interval for the patient population and method.
  • Distinguish named reactive-supportive neutrophil morphology from common stain or preparation artifacts and resolve an immature-granulocyte flag through local smear-review criteria.
  • Use a dated prior CBC as duration evidence and communicate or escalate a verified pattern under the local pathway without assigning an etiology.

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

6 sources

  1. 1. Clinical and Laboratory Standards Institute. H20, Reference Leukocyte Differential Count (Proportional) and Evaluation of Instrumental Methods, 3rd ed. Accessed 2026-08-16.

    Source note · consensus standard

  2. 2. College of American Pathologists. Hematology and Coagulation Checklist, current CAP Accreditation Program checklist. Accessed 2026-08-16.

    Source note · accreditation standard

  3. 3. 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. Accessed 2026-08-16.

    Source note · consensus standard

  4. 4. American Society of Hematology. Malignant or benign leukocytosis. Hematology ASH Education Program. 2012;2012:475-483. Accessed 2026-08-16.

    Source note · peer-reviewed literature

  5. 5. Tahmasebi H, Higgins V, Bohn MK, et al. CALIPER Hematology Reference Standards (I): Improving Laboratory Test Interpretation in Children (Beckman Coulter DxH 900-Core Laboratory Hematology System). Am J Clin Pathol. 2020;154:330-341. Accessed 2026-08-16.

    Source note · peer-reviewed reference-interval study

  6. 6. WHO Classification of Tumours Editorial Board. Haematolymphoid Tumours, 5th ed., Vol. 11. IARC; 2024. Accessed 2026-08-16.

    Source note · professional society guidance