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Hematology

Hematology Testing Updates (Corewell Health West Michigan)

Effective Wednesday, July 30, 2025, changes to result reporting will be implemented across all Hematology Departments at Corewell Health Laboratories. These updates will help align all regions within Corewell Health Hematology Departments to provide a high-quality and standardize patient care experience.

The following are the most impactful changes for the Corewell Health West Michigan Region:

  • The Immature Platelet Fraction (IPF) will continue to be performed once every 24 hours if the platelet count is <100 x10^9/L, but the IPF results will now be located within the CBC.
  • The ‘immature cells’ component of the manual differential will be changed to ‘other cells’.
  • The Absolute Neutrophil Count (ANC) within a CBC w/Differential order will be EITHER an Automated ANC or a Manual ANC.
    • A CBC with Differential order with an automated differential will receive the automated ANC. A CBC with Differential order reflexing to a Manual Differential will receive a manual ANC.
  • The RBC Morphology will no longer include Anisocytosis, Microcytosis, or Macrocytosis components.
  • The RBC Morphology grading will change from “Moderate/Many” to “Present” for the following components:
    • Sickle Cells
    • Basophilic Stippling
    • Howell Jolly Bodies
    • Pappenheimer Bodies
    • Toxic Granulation
    • Dohle bodies
    • Vacuolated Neutrophils
    • Neutrophil Hypogranulation
    • Giant Platelets
  • The following RBC Morphology components will STILL be reported as Moderate/Many:
    • Hypochromia
    • Polychromasia
    • Schistocytes (Few, Moderate, Many)
    • Bite Cells
    • Spherocytes
    • Target Cells
    • Teardrop Cells
    • Acanthocytes
    • Blister Cells
    • Echinocytes
    • Macro Ovalocytes
  • Given the limited clinical utility and labor intensiveness of performing RBC counts, lower reportable limit for non-cerebrospinal fluid (non-CSF) body fluid red blood cell (RBC) counts will be updated to 2000 cells/uL. This means, if an RBC count on a non-CSF Body Fluid is <2000 cells/uL, Epic will report out the RBC count as <2000 cells/uL.
    • CSF will continue to report out all RBCs present within the cell count.

References:

  1. Kjeldsberg CR, Hussong, JW: Body Fluid Analysis. ASCP Press; 2015
  2. Collins, l. Examination of Body Fluids: Evaluating Gross Appearance; Performing Cell Counts. Clin Lab Sci 2009;22(1):46
July 18, 2025 by
General Information, Hematology

CBC Unit Updates

On Monday, November 20, 2023, Corewell Health Laboratories West will adjust several hematology result components units of measure. The numerical results will be unchanged, the metric units will be adjusted to achieve standardization across the system and will align our labs with the International Society of Laboratory Hematology’s recommendations for standardization of hematology reporting units in blood counts.

The following parameter will be adjusted because of this change: Continue Reading

November 15, 2023 by
General Information, Hematology

Update: Complete Blood Count (CBC)

Starting November 29th, 2022, Corewell Health West, Hematology Laboratories will begin reporting absolute counts for white blood cell (WBC) manual differentials, in addition to relative (percentage) counts. The WBC differential count determines the number of each type of white blood cell present in the blood. It can be expressed as a percentage or as an absolute value. Of these, the absolute value is much more important than the relative value, given that clinically relevant WBC elevations and declines are defined by their absolute numbers, not by their relative proportions, and there is potential for error if this conversion is performed outside the laboratory. Continue Reading

November 23, 2022 by
Hematology

Result Reporting Change of Nucleated Cells in Cerebrospinal Fluid (CSF) Counts

Cell Count w/ Differential if indicated, Cerebrospinal Fluid [LAB2111025] and Cell Count with Differential, Cerebrospinal Fluid (Pediatric Oncology) [LAB212] currently result nucleated cell counts as a White Blood Cell (WBC) count.

Effective Tuesday, August 16, 2022, the WBC component will be removed and instead reported as a Total Nucleated Cell (TNC) Count for CSF.

Continue Reading

August 8, 2022 by
General Information, Hematology

Test Update: Cell Count with Differential, Body Fluid

Beginning Tuesday, January 4, 2022, Spectrum Health Laboratories will include an automated neutrophil (PMN) count on Cell Count with Differential, Body Fluid (LAB210) orders for peritoneal body fluids.   This component will be displayed in Epic as an absolute PMN count, body fluid.

• The absolute PMN count in the peritoneal fluid is calculated by multiplying the total nucleated cell count by the percentage of PMNs in the differential.

• This calculation aids in the diagnosis of spontaneous bacterial peritonitis (SBP).

• The diagnosis of bacterial peritonitis is established by a positive peritoneal fluid bacterial culture and an elevated peritoneal fluid absolute PMN count (≥250 cells/uL).

• Epic will automatically calculate the absolute PMN count in peritoneal body fluids based on the manual differential data.

• This component ONLY calculates for Cell Count with Differentials (LAB210) on PERITONEAL BODY FLUIDS Continue Reading

December 28, 2021 by
Chemistry, Compliance & Safety, General Information, Hematology, Hemostasis/Coagulation, Microbiology, Referral/Sendouts

CSF Priorities on QNS Specimens

When a Cerebrospinal fluid (CSF) specimen arrives into the laboratory and is deemed Quantity Not Sufficient (QNS) for ordered testing, the ordering provider is contacted to identify testing priorities. Occasionally, the laboratory is unable to secure these priorities.

If the lab is unable to secure priorities from the ordering provider within an hour of collection, the following will occur:

1. We will move forward with the Cell count with differential, Culture, and Protein/Glucose

2. The rest of the ordered testing will hold until we can clarify the priorities

Laboratory is partnering with Epic Beaker to discover if a prioritization of orders, upon CSF order entry, is possible.

If you have questions or concerns, please use the “Contact Us” link above.

June 9, 2021 by
General Information, Hematology

Cell Count Update – Specimen Rejection Criteria

The Spectrum Health Regional Laboratory Hematology Department has updated rejection criteria for the orderables, Cell Count w/ Differential, Body Fluid and Cell Count, Body Fluid.  Spectrum Health Hematology will no longer perform cell counts on specimens which are not from a sterile body cavity (e.g. wound drainage, abscess, pus, etc.).  Unacceptable specimens submitted to the Hematology Department for cell counts will not be performed and the test will be credited. Continue Reading

July 5, 2019 by