Study of automated hematology analyzer’s scatterplot patterns in white blood cell disorders

Background: Automated hematology analyzers produce scattergrams that can be used as screening tool for various hematological conditions and efficiently shorten turnaround times. Aim was to study scattergram patterns of various while blood cell disorders and assess their efficacy compared to a peripheral blood smear for diagnosis of various disorders. Methods: Scattergram findings generated by UniCel® DxH 800 automated hematology analyzer, a 5-part differential analyzer. The graphic displays have been compiled over a period of 3 months from blood samples received for CBC. Samples that the counter flagged as abnormal for white blood cell were chosen. Based on the scatterplots, a preliminary diagnosis was formed. It was compared with the peripheral blood smear (PBS) findings which were taken as the gold standard. Results: The scatterplots showed unique patterns for various disorders on the basis of location, shape, size, density of the cells and their clustering. The scattergram analyser showed 90% sensitivity and 88% specificity for diagnosing hematological disorders. A 97-100% accuracy rate was reported showing excellent correlation between PBS result and WBC parameter result in cell counter analyzers. Conclusions: Not all cases of haematological malignancy exhibit cytopenias or cytosis at initial presentation. Therefore, these scatter plots offer helpful information that prompts a hematopathologist to suspiciously screen the peripheral smear in cases with normal counts. Scattergram analysis suspects a diagnosis earlier than peripheral smear examination. Given their strong correlation with a variety of WBC disorders and confirmed by PBS, WBC scatterplots can be used as a screening tool

Robinson’s cytological grading of breast carcinoma: it’s prognostic implications and correlation with bloom Richardson’s histological grading of breast cancer

Background: Cytological grading on aspirates of breast carcinoma is a useful tool for surgical maneuver and prognosis. The aim of the study is to find out the utility of grading in malignant breast tumors using Robinson’s cytological grading on FNAC and correlating it with modified bloom-Richardson’s histopathological grading of breast carcinoma along with lymph node status assessment post-operatively by histopathological examination. Methods: This prospective study was carried out in 40 cases of invasive duct carcinoma of breast for a period of one and half year duration from December-2019 to July-2021. This study was done in department of pathology, Surat municipal institute of medical education and research (SMIMER), Surat. In all these cases the cytological diagnosis was confirmed by histological examination. All cases were graded by using Robinson’s grading system. All these cases were also correlate with bloom Richardson’s grading system on histopathology in mastectomy specimen. Result: Robinson’s cytological grading correlated well with bloom Richardson’s histopathological grading. In this study of forty cases, thirty-three cases (82.5%) show concordance between cytologic and histologic grading system. Rest of the seven cases (17.5%) show discrepancy. Conclusions: Thus, In the most of the cases, cytological grading of breast carcinomas correlate with histopathological grading and may be useful as a prognostic marker. It was concluded that the cytological grading should be included in all FNAC reports. So that appropriate decision regarding the preoperative neoadjuvant chemotherapy can be made and overtreatment of low-grade cancers has been avoided