*Automated peripheral blood cell counts and differentials, which have instrument flags or histogram abnormalities, are automatically reviewed by scanning a peripheral blood smear to determine consistency with the automated results. Slides showing red cell or platelet inconsistencies with automated results are documented with appropriate comments, and slides showing inconsistencies in white cell parameters are documented with a manual differential.
Pathologist Bone Marrow Consultation
Bone marrow tests are performed on outpatients Monday through Friday, on an appointment basis, by board-certified hematopathologists and nurse practitioners in the Department of Clinical Pathology. Patients should be scheduled by calling the Appointment Center at (248) 432-3100. Patients are required to bring a prescription slip requesting a bone marrow test from the referring physician and a list of medications. Patients belonging to an HMO must also bring pre-authorization for the bone marrow test from their insurance company. A concise clinical laboratory critique should also be sent. Full work-up of hematologic disorders is available, including cytochemistry, immunohistochemistry, flow cytometry, cytogenetics and molecular analysis for gene rearrangements. A comprehensive interpretative report, which integrates the available clinical and laboratory information, is issued on each case.
Pathologist Consultation with CBC/Differential and Reticulocyte Count
Consultation is reserved for difficult cases where morphologic review and correlation with laboratory work-up will improve patient diagnosis. CBC/ differential and reticulocyte count are performed and reviewed by a hematopathologist with correlation of findings with the patient history, previous available laboratory data, current laboratory findings, and peripheral blood morphology. Appropriate diagnostic procedures (i.e., flow cytometry, molecular studies, cytochemistry, etc.) are used as necessary for full evaluation of peripheral blood abnormalities. A comprehensive report is issued within one to two working days. A brief clinical history and pertinent laboratory data should be provided in writing by the requesting physician and a written order for a pathologist consult is required. A medication list is also required.