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patient, are always a critical result.

verify the automated result. The criteria for performing either a full differential or a "diff scan," are usually well outlined in the standard operating procedure for each clinical facility. Generally, these criteria include items such as total leukocyte count, lymphocytes, and monocytes above a certain level, an abnormal scatter plot, or thrombocytopenia. Patients whose peripheral smears need review usually represent a pool of individuals who are seriously ill or whose conditions are deteriorating or changing. Needless to say, reviewing peripheral smears on these patients requires a high level of morphological skill from the laboratory professional.

Relative Versus Absolute Values

Relative and absolute counts are terms referring to the white cell differential. The absolute count refers to the count derived from the total white count multiplied by the percentage of any particular white cell. The relative

Table 9.6 O Absolute Reference Range for Adult Differential*

• Neutrophils

1.4 to 6.5

• Lymphocytes

1.2 to 3.4

• Monocytes

0.11 to 0.59

• Eosinophils

0.0 to 0.5

*All values X109/L.

*All values X109/L.

count refers to the percentage of a particular cell counted from the 100 WBC differential. Absolute reference ranges have been compiled for each cell in the white cell differential (Table 9.6). For an example of how to calculate and interpret the relative and absolute count, see below: If the WBC is 5.0 X 109/L

And the differential Segmented neutrophils: 40% reads: (Ref. range = 50% to 70%)

Lymphocytes: 55% (Ref. range

Then the absolute count of lymphocytes would be 5000 X 0.55= 2500.

Reference range for absolute lymphocyte count = 1200 to 3400

In this patient, there is a relative lymphocytosis but not an absolute lymphocytosis.

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