An analytical study of histograms and their correlation with peripheral blood smear findings

Buch Archana C.; Patro Namrata; Bavikar Rupali; Gore Charusheela R.

Volume : X, Issue : IV, April - 2020

An analytical study of histograms and their correlation with peripheral blood smear findings

Buch Archana C. , Patro Namrata, Bavikar Rupali, Gore Charusheela R.

Abstract :

Background: Histograms produced by automated hematology analyzers are the graphical representation of numerical data of different cell populations. The varying shapes and patterns are useful in identifying the underlying pathology. Aims: To correlate RBC, WBC and Platelet histogram abnormalities with peripheral blood smear findings. Methods: A descriptive cross sectional study was undertaken on 500 patients with abnormal histograms and/or abnormal peripheral smears. Alterations in RBC, WBC and platelet histograms were analyzed with their respective peripheral smear findings. Pearson’s Chi square test and Fisher exact test were used for statistical analysis. Statistical analysis used: Pearson’s Chi square test and Fisher exact test. Results: Of 500 cases, 85.2% showed RBC histogram defects (n=426), 4.2% had WBC histogram defects (n=21), and 3.6% showed platelet histogram defects (n=18). In RBC histogram defects, majority had a left shift (66.8%) followed by right shift (17.8%) and bimodal peak (0.6%) respectively. WBC defects included WU (n=5), WL (n=1), F1 (n=4), F2 (n=1), F3 (n=3), T1 (n=3) and T2 (n=3). Platelet histograms revealed lower peak, PL (n=4), upper peak, PU (n=3) and multiple peak, MP (n=1). PBS showed RBC defects (n=420), WBC defects (n=171) and platelet defects (n=117). Correlation between RBC, WBC and platelet histogram defects with PBS was statistically significant (P 0.0001). The number of pathological samples picked up by the automated analyzers were significantly less for WBC and platelet abnormalities as compared to RBC. Conclusion: Histograms should be used as a screening method to pick up pathological samples. These samples should then be followed by a peripheral smear examination for confirmatory diagnosis.