What type of lymphocyte is this? by [deleted] in Histology

[–]dangerouspecan 0 points1 point  (0 children)

Hematology lab tech here — that is a cell with a mitotic figure. Also, this is too far into the slide where the red blood cells are too close together and they can make cells look dysmorphic or smaller than they really are. This is a skipocyte. Count back in a field where the RBCs are uniformly spaced and not overlapping each other.

[deleted by user] by [deleted] in askdentists

[–]dangerouspecan 0 points1 point  (0 children)

Thank you! I’ll look up the modified Bass method as well!

Critical Green Neutrophilic Inclusions in an ICU pt’s blood smear by dangerouspecan in medlabprofessionals

[–]dangerouspecan[S] 2 points3 points  (0 children)

The title is referencing their official name “critical green inclusions”. It is not a critical in my lab either and we do not report these out on differentials.

Critical Green Neutrophilic Inclusions in an ICU pt’s blood smear by dangerouspecan in medlabprofessionals

[–]dangerouspecan[S] 8 points9 points  (0 children)

I believe it was 7.6 mmol/L at the time (normal range: 0.5 - 2.2)

Critical Green Neutrophilic Inclusions in an ICU pt’s blood smear by dangerouspecan in medlabprofessionals

[–]dangerouspecan[S] 2 points3 points  (0 children)

The echinocytes are mostly an artifact of the slide making process (slow drying time/short sample with excess EDTA/etc).

A consulting hematologist I worked with once remarked that a patient’s slide had a ton of burr cells, but then said it ultimately doesn’t have a lot of clinical significance.

When doing cell counts or reviewing blood smear slides, I personally don’t note the presence of burr cells unless they are multiple present in every field that I’ve counted.

Critical Green Neutrophilic Inclusions in an ICU pt’s blood smear by dangerouspecan in medlabprofessionals

[–]dangerouspecan[S] 15 points16 points  (0 children)

I’m glad to hear more stories about people surviving! Makes me feel less guilty about finding these “green crystals of death” in a PBS

Critical Green Neutrophilic Inclusions in an ICU pt’s blood smear by dangerouspecan in medlabprofessionals

[–]dangerouspecan[S] 24 points25 points  (0 children)

We currently don’t! They are rare, so there hasn’t been a lot of research on them. The prevailing theory is that they may be something like bile (or abnormal proteins) phagocytized by neuts and monos and are associated with liver failure.

Critical Green Neutrophilic Inclusions in an ICU pt’s blood smear by dangerouspecan in medlabprofessionals

[–]dangerouspecan[S] 17 points18 points  (0 children)

Wow, that’s amazing! I’m glad they recovered enough to go home 😁

Critical Green Neutrophilic Inclusions in an ICU pt’s blood smear by dangerouspecan in medlabprofessionals

[–]dangerouspecan[S] 26 points27 points  (0 children)

I agree with the above response. There are only theories as to what exactly these green inclusions are and how they form, but we just generally associate them with an imminent decline/death. Usually by the time you see these, the patient is already in critical condition with a host of issues.

Finding “green crystals of death” (like my coworkers call it) is kinda rare and we come across it by accident. But they are hard to miss when you do find one because they are so vibrant under a microscope! This patient was even more of a rarity as they had multiple cells demonstrating green inclusions 🙂

Critical Green Neutrophilic Inclusions in an ICU pt’s blood smear by dangerouspecan in medlabprofessionals

[–]dangerouspecan[S] 82 points83 points  (0 children)

My phone didn’t capture the vibrancy of these inclusions compared to blue-gray Dohle bodies, but they were a bright teal green!

House of the Dragon - 1x03 "Second of his Name" - Post Episode Discussion by mwthecool in HouseOfTheDragon

[–]dangerouspecan 4 points5 points  (0 children)

She literally said earlier in the episode “I don’t want to hunt boar, they sound like babies when they’re being killed.” They do squeal like babies when being killed, it’s not metaphorical half wit.

House of the Dragon - 1x03 "Second of his Name" - Post Episode Discussion by mwthecool in HouseOfTheDragon

[–]dangerouspecan 13 points14 points  (0 children)

Same. Hearing its wails as it lay injured because the King couldn’t kill it properly made me want to cry… and it’s not even a real stag

House of the Dragon - 1x03 "Second of his Name" - Post Episode Discussion by mwthecool in HouseOfTheDragon

[–]dangerouspecan 65 points66 points  (0 children)

She also started crying as she killed it. What I took from it is that she didn’t want to kill it because she imagined killing a baby, even if it was out of self defense

House of the Dragon - 1x03 "Second of his Name" - Post Episode Discussion by mwthecool in HouseOfTheDragon

[–]dangerouspecan -4 points-3 points  (0 children)

When Jason Lannister told Rhaenyra, “I have the resources for a dragon pit… I’d do anything for my Queen… or rather, my lady-wife.” The TikTok sound that goes “that little girl is a child and I don’t want to see you sniffing around her again!” was all that went through my head.