Make the Most of Your Clin Path Submission

By Dr. Taylor Hanson, veterinary resident

CBC and Blood Smears

We currently offer three tiers of analysis for blood smears:

1. Standard CBC: These blood samples will be closely evaluated manually by our certified medical technologists, even if the sample was not submitted specifically for pathologist review. Any samples with significant abnormalities (e.g., infectious organisms, atypical or neoplastic cells, unusually high leukocyte counts) will be flagged for pathologist review and will receive further comment on the report at no extra cost.

2. CBC with Pathologist Review: These submissions incur an additional fee. The smear will be evaluated by a pathologist even if the sample does not have qualifying “flags” for a pathologist review. The sample will be analyzed with our hematology analyzer to provide automated CBC data as usual, and the pathologist will provide a brief statement that confirms findings or elaborates on atypical features, if present.

3. CBC with Cytology: This tier represents the highest level of smear analysis, although hematology analyzer data are not included. A pathologist will provide a description of all three cell lines (erythrocytes, leukocytes, and platelets), comment on significant abnormalities, and include a complete interpretation. We are able to provide the most thorough assessment and interpretation when this test is ordered with a CBC (requires concurrent submission of an EDTA sample) or when concurrent results from a benchtop hematology analyzer are attached. This test is most useful when disease affecting multiple cell lines is present or for persistent or unexplained hematological abnormalities.

If submitting blood for CBC with pathologist review or cytology, please remember to include history that indicates which hematologic cell line(s) is/are of most clinical concern, what conditions are being considered, and anything you would like us to specifically address in our comments. This step ensures that our pathologists can provide you with the most tailored, helpful information to guide further diagnostic testing or treatment.

Thorough History: Help Us Help You!

For all cytology submissions, please remember to include full patient signalment, including age, breed, sex, and neuter status. Knowing this information helps our pathologists prioritize differentials and provide a more specific and helpful interpretation in many cases.

All cytology submissions should also include a short, pertinent patient history on the back of the form, along with location of the lesion. Specifying whether a “thoracic mass” is cutaneous,

subcutaneous, intra-thoracic, etc., is extremely helpful for interpretation of findings and prioritization of differential diagnoses.

If submitting a sample from a visceral organ, please also indicate why this test is being performed, rather than simply denoting the site. For example: Is the spleen uniformly enlarged? Has a splenic nodule or mass been identified? Is there clinical concern for metastasis to this site?

Even knowing how the sample was obtained can sometimes be important. For example, for cutaneous lesions, was this sample obtained via fine-needle aspiration or skin impression? All this information helps our pathologists interpret their findings within the clinical context and ultimately provide clinicians with a more helpful interpretation and tailored recommendations.

Our goal is to provide you with thorough and accurate information so you are able to efficiently move on to the next relevant diagnostic steps or treatment.