Omar Adwan: Summary of Blood Smear Examination Process
Omar Adwan, Medical Laboratory Technologist at Modawah lab center, shared a post on LinkedIn:
“Summary of Blood Smear Examination Process
1.Start with Basic Cell Parameters
Review WBC, Platelet, and RBC values from the automated analyzer (e.g., Count, MCV, MCH, MCHC, RDW, Hb, Hct).
Use these parameters to anticipate possible abnormalities:
- High WBC – Possible infection or leukemia
- Low Platelets – Risk of abnormal bleeding
- Abnormal RBC parameters – Anemia or red cell disorders
2.Evaluate Red Blood Cell (RBC) Morphology
Assess size, color, shape, and uniformity of red blood cells.
Key classification criteria:
By size:
- Normocytic (normal)
- Microcytic (small)
- Macrocytic (large)
By color:
- Normochromic (normal)
- Hypochromic (pale)
Important:
Begin by determining the RBC type based on analyzer parameters to identify the predominant pattern. Then, examine the smear under the microscope for additional abnormalities.
Following this sequence provides a structured approach and improves diagnostic accuracy.
3.Examine All Cell Lines for Abnormalities on the Slide
WBC (White Blood Cells):
- Immature forms
- Blast cells
- Hypersegmented neutrophils
Platelets:
- Platelet clumping
- Giant platelets
RBC (Red Blood Cells):
- Target cells
- Spherocytes
- Schistocytes
- Anisocytosis
Key Takeaway:
Review analyzer results, than classify RBC type, after that identify all morphological abnormalities.
This systematic approach ensures comprehensive, accurate reporting and good correlation with automated analyzer findings.”

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