A compact 5-diff solution

Name: A compact 5-diff solution
Uploaded: 2017-07-05T15:32:22+00:00
Duration: PTM21S39
Channel: Dominic Arnold
Description: A compact 5-diff solution

BC-5300 Small & Big Title screen

A compact 5-diff solution
Small size Big content

Complete solution for hematology tests
Economical running Accurate and stable performance Friendly user interface Excellent information management Easy maintenance

Complete CBC+5DIFF result
∑ WBC Total No Lymphocytes (#,%) Monocytes (#,%) Neutrophils (#,%) Eosinophils (#,%) Basophils (#,%) DIFF WBC/BASO RBC Total No HGB HCT MCV MCH MCHC RDW – CV,SD PLT Total No MPV PCT PDW – CV 23+4 Parameters RUO Atypical Lymphocytes (#,%) Large Immature Cell (#,%)

5 Reagents 2 YEAR SHELF LIFE

QC & Calibrator Original quality control and calibrator
BC-5D and SC-CAL PLUS Participation in online QC program CBC-Monitor

Economical running 20 ul sample volume 60 tests/hr throughput
whole blood & capillary blood 60 tests/hr throughput report ready within 1min Lateral needle aperture avoid sample blockage 0 daily maintenance automatic shutdown

Save every drop of reagent
Reagent Consumption Save every drop of reagent Low reagent consumption per test Low dead volume per bottle Less maintenance

Correlation with microscopic counting

Correlation with Beckman Coulter LH750

Integrated information
Integrate-All for Operation, Maintenance & Management Patient Information Function Shortcut Flags Test Results 40000 Menu Graphics

Easy search and delta-check capability
Patient Record Search Trend Screen Workload Statistics

Special Customization on report styles
Insert lab logo or patient photo Report Headline Patient information Customize results: parameters graphics flags microscopic

Easy and convenient maintenance
Auto maintenance set-up “Double-click” maintenance “Single-click” error removal

WBC 5-PART DIFF TECH Smart algorithm Advanced technology
Laser scatter Flow cytometry Chemical dye Smart algorithm Digital sheath flow

Chemical dye Chemical dye

Flow cytometry Flow cytometry

Laser scatter Laser scatter

DC method for basophils
WBC/BASO Bath RBC Lymphocyte Monocyte Basophil Eosinophil Neutrophil LH Lyse 525nm HGB LH lyse shrinks the white blood cells to reduce the size except for basophils;

Digital sheath flow Digital sheath flow

After Digital sheath flow
Good correlation with XE-2100, which uses DC- sheath-flow to test RBC.

Clinical Case Study

Scattergram and flags DIFF BASO Neu Bas Mon Eos Bos Lym

Microscopic examination results
Normal sample Male, 27 years old, volunteer, healthy Microscopic examination results WBC DIFF (n=200) Neutrophilic band granulocyte 1% Neutrophil 54% Lymphocyte 37% Monocyte 4% Eosinophil 3.5% Basophil 0.5% RBC morph Normal PLT morph 2 Lymphocyte 1 Neutrophil Under the microscope, the morphology of the erythrocytes, platelets and leukocytes is normal. No immature or atypical cell is observed.

Normal sample Analysis results are normal. The WBC populations are well differentiated. The aggregations in the WBC DIFF scattergram include ghost cells, lymphocytes, monocytes, neutrophils and eosinophils. The aggregations in the BASO histogram include basophils and non-basophils. The RBC and PLT histograms are normal. No flag is displayed.

Neutrophilia Female, 16 years old, outpatient Microscopic examination results WBC DIFF (n=200) Neutrophilic band granulocyte 3% Neutrophil 81% Lymphocyte 10% Monocyte 3.5% Eosinophil 2% Basophil 0.5% RBC morph Normal PLT morph 1 Neutrophil 1 Neutrophil 1 Neutrophil Under the microscope, most leukocytes are poly-segmented neutrophils In the microscopic field image: four poly-segmented neutrophils are present 1 Neutrophil Diagnosis: pyrexia (pathogeny to be confirmed)

Neutrophilia DIFF results: Neu number increases significantly (%: 0.866; #:15.92  109/ L In the DIFF scattergram, the area denoted by the arrow is brighter than normal, indicating an intense aggregation of spots (for neutrophils). WBC Flag messages: Neutrophilia; Lymphopenia; Leucocytosis. Neutrophilia can be categorized into physiological neutrophilia and pathological neutrophilia. Physiological neutrophilia is generally not associated with a qualitative change of leukocytes. It is related to age, different time of the day, pregnancy, exercises, pain and emotion. Pathological neutrophilia can be further divided into reactive neutrophilia and hyperplastic neutrophilia. Reactive neutrophilia is an acute reaction of human body towards various pathogenic stimulations. Hyperplastic neutrophilia is a type of hemopoietic stem cell clonal disease with severe granulocyte hyperplasia present in the hematopoietic tissues. This can be found in patients with granulocytic leukemia or bone marrow hyperplastic diseases.

Eosinophila Female, 25 years old, outpatient Microscopic examination results WBC DIFF (n=200) Neutrophil 42.5% Lymphocyte 28 % Monocyte 4.5 % Eosinophil 24.5% Basophil 0.5% RBC morph Normal PLT morph 1 Neutrophil 1 Neutrophil 2 Eosinophil Under microscopy, the Eos proportion increases. 2 neutrophil and 2 eosinophil can be observed in the vision shot. 2 Eosinophil Diagnosis: edema (checking for pathogenesis)

Eosinophila DIFF results: Eos number increases significantly (%:0.215; #: 2.08  109/ L); In the DIFF scattergram, there is a significant increase of red spots (for eosinophils) and increase of Eos proportion. WBC Flag message: Eosinophilia Eosinophil is a significant type of granulocyte that is capable of inhibiting allergic responses, phagocytizing, and is involved in immunological reactions to parasites. Elevated eosinophil count is commonly seen in patients with parasitic diseases, allergic reactions and dermatological diseases such as eczema, exfoliative dermatitis, psoriasis. Increased eosinophil count in chronic granulocytic leukemia, polycythemia vera, multiple myeloma is not unusual. Eosinophilia may also be seen in patients with malignant tumors, infectious diseases, rheumatic diseases, pituitary gland anterior lobe deterioration, adrenal cortex deterioration and allergic interstitial nephritis.

Immature cell Male, 34-year-old, outpatient Microscopic examination results WBC DIFF (n=200) Myelocytes 1% Metamyelocytes 2.5% Neutrophilic band granulocyte 2% Neutrophil 66.5% Lymphocyte 22.5% Monocyte 3.5% Eosinophil 1.0% Basophil RBC morph Normal PLT morph 1 Myelocyte Under microscopy, a trend of left shift for neutrophils and promyelocytes are observed. The cell in the left of the vision shot shown on this page is a myelocyte. 2 Lymphocyte Diagnosis: adult still

Immature cell In the DIFF scattegram, there is an aggregation of spots in the LIC area (denoted by the arrow). There is no clear boundary to differentiate Neu spots and Mon spots.DIFF results of related WBC populations (Neu＃/％, Mon＃/％) are flagged with “?” ，indicating these results may be affected by abnormal cells and a microscopic examination is suggested. WBC Flag message: Immature cell? Immature cells, normally absent from peripheral blood, are increased in conditions such as bacterial infections, acute inflammatory diseases, cancer (particularly with marrow metastasis ), acute transplant rejection, surgical and orthopedic trauma, myeloproliferative diseases, steroid intake and pregnancy. Immature cells include promyelocyte, myelocyte ,metamyelocyte, premonocyte and prelymphocyte.

Atypical lymphocyte Female, 2 years old, inpatient Microscopic examination results WBC DIFF (n=200) Neutrophilic band granulocyte 1% Neutrophil 14% Atypical lymphocyte 5 % Lymphocyte 75.5 % Monocyte 3% Eosinophil 0.5 % Basophil 1.0% RBC morph Normal PLT morph 1 Atypical lymphocyte Under microscopy, the ALY proportion increases. The vision shot on this page displays a mononuclear atypical lymphocyte. Diagnosis: bronchopneumonia; virus infection confirmed

Atypical lymphocyte In the DIFF scattegram, there is an aggregation of spots in the ALY area (denoted by the arrow). There is no clear boundary to differentiate Lym spots and Mon spots. DIFF results of related WBC populations (Lym＃/％, Mon＃/％, Eos＃/％) are flagged with “?” ，indicating these results may be affected by abnormal cells and a microscopic examination is suggested. WBC Flag messages: Abn./Atypical Lym? Lymphocytosis; Neutropenia. Atypical lymphocytes, also known as reactive lymphocytes, are enlarged and elongated lymphocytes with an elliptic nucleus. They are usually associated with viral illnesses when normal lymphocytes are stimulated by the viral antigens. They are commonly seen in infectious mononucleosis, infectious hepatitis, measles, viral pneumonia, pertussis-like syndrome, influenza, epidemic hemorrhagic fever and common cold.

Iron Deficiency Anemia (IDA) Female, 40 years old, outpatient Microscopic examination results WBC DIFF (n=200) Neutrophil 65% Lymphocyte 30% Monocyte 3.0% Eosinophil 1.5% Basophil 0.5% RBC morph Cells vary in size PLT morph Normal 1 Neutrophil Under microscopy, the erythrocytes vary in size and WBC morph normal. The leukocyte shown in the vision shot on this page is a neutrophil. She had a CBC routine test after receiving treatment for iron deficiency anemia.

Iron Deficiency Anemia (IDA)
Normal count results, slight MCV decrease and diamorphologic RBC histogram indicate good recovery of erythrocytes. RBC Flag messages:Diamorphologic; Anisocytosis Iron deficiency anemia occurs when the dietary intake of iron or its absorption becomes insufficient. Iron is a mineral necessary to form hemoglobin, an oxygen carrying protein found in red blood cells. IDA is the most common form of anemia. Approximately 20% of women, 50% of pregnant women, and 3% of men are diagnosed with iron deficiency anemia. About 30% of iron is also stored as ferritin and hemosiderin in the bone marrow, spleen and liver.

Chronic Myelocytic Leukemia (CML) Male, 32 years old. Chief disease: leucocytosis for 2 years Microscopic examination results WBC DIFF (n=200) Myelocytes 1.0% Metamyelocytes Neutrophilic band granulocyte 2.0% Neutrophil 46% Atypical Lymphocyte Lymphocyte 37% Monocyte 8.0% Basophil 4.0% RBC morph Normal PLT morph 2 Basophil Promyelocytes are observed under microscopy. Number of basophils increases significantly. In the vision shot on this page, there is a neutrophilic segmented granulocytes and a basophil. 1 Neutrophil Bone marrow examination result shows a possibility of chronic myelocytic leukemia.

Chronic Myelocytic Leukemia (CML)
In the DIFF scattergram, there are a few spots scattered in the immature cell area and the abnormal/atypical lymphocyte area (denoted by the red arrow). It indicates an abnormal WBC morph, so microscopic examination is suggested. WBC Flag messages: Immature Cell? Abnormal/Atypical Lymphocyte? Basophilia The number of basophils increases, and immature cells are observed, which indicates a possibility of chronic myelocytic leukemia. Chronic Myelocytic Leukemia (CML) is a clonal proliferative disease which originates from the hematopoietic stem cells with primary changes in myelocyte proliferation. The disease is typically diagnosed in individuals aged between 20 and 50. One of the most distinctive features is enlarged or swollen spleen. From the cytogenetic perspective, a positive CML diagnosis is confirmed when the Philadelphia chromosome test is positive and the BCR/ABL fusion gene is detected.

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