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A Staining Artefact Presumed to be Pathology in a Patient Investigated for Megaloblastic Anaemia and Myelodysplastic Syndrome: A Case Study at Groote Schuur Hospital

Monalisa Ntobongwana

Artefacts are structures that are not normally present in well prepared smears. Well stained smears are the cornerstone of diagnostic haematology and this requires properly stained smears achieved by adherence to standard operating procedures (SOPs) to ensure reliability of results. Artefacts on smears may baffle the examiner and may in fact be assessed as real pathology by an inexperienced examiner or conceal real pathology. This case report describes a patient who was referred to the haematology department for work-up of a macrocytic anaemia to exclude megaloblastic anaemia and myelodysplastic syndrome. The initial blood smear processed consisted of numerous basophilic stippling-like inclusions which was perplexing as the degree of BS has never been encountered before. This prompted a repeat of the blood smear which showed resolution of the artefact. Basophillic stippling can be seen in megaloblastic anaemia and myelodysplastic syndromes.