Peripheral Blood film

A peripheral blood film (PBF) is the result of a laboratory workup that shows blood cells and other structures in the blood, which includes microscopically viewing blood cells smeared on a slide.

Keywords: Peripheral blood smear, Blood smear analysis, Blood cells morphology.

During the procedure, red and white blood cells and platelets are observed for the appearance, shape and count.

Complete blood count (CBC) is counting the number of  red blood cells, white blood cells, and platelets.

Complete blood count (CBC)

Red blood cells (RBC) / Erythrocytes: Men – 4.0 to 5.9 x 1012/L; Women – 3.8 to 5.2 x 1012/L

White Blood Cells (WBC) / Leukocytes: 4.5 to 11.0 × 109/L

Haemoglobin: Men – 130–180 g/L (13–18 g/dL); Women – 120–160 g/L (12–16 g/dL)

Hematocrit: Volume percentage of erythrocytes in blood. 41.5% to 50.4% for men; 35.9% to 44.6% for women. (Other names: packed cell volume (PCV), volume of packed red cells (VPRC), or erythrocyte volume fraction (EVF))

HCT↓HCT↑
AnemiaCongenital heart ♥ disease
BleedingCor pulmonale
LeukemiaDehydration
MalnutritionErythrocytosis
Over hydrationHypoxia
Vitamin B12, B6, Folate deficiencyPulmonary fibrosis
Polycythemia vera

Mean Corpuscular Volume (MCV): Measurement of the average size of red blood cells.

Mean corpuscular Hemoglobin (MCH): Average amount of hemoglobin present in a single erythrocyte. 27-32 picograms (pg)/cell

Mean corpuscular Hemoglobin Concentration (MCHC): Average concentration of hemoglobin present in a single erythrocyte. 32% -36 %

Red Blood Cell Distribution Width (RDW): It measures the range of variation in the volume and size of erythrocytes. normal range is 11-15 %. Also called as RDW-CV / RCDW / RDW-SD. RBC with increase RDW are called as anisocytosis.

Leukocyte Differential Count:

  • neutrophils – 45%-70%
  • lymphocytes –  20%-40%
  • monocytes – 2%-8%
  • eosinophils – 0%-4%
  • basophils – 0%-2%

A “left shift” is being used when immature blood cells, particularly neutrophil band cells, appear in the blood.

Platelet count: normal range is 150- 400 x 109/L. Thrombocytopenia and thrombocytosis are less platelet and high platelet count respectively. Mean Platelet volume (MPV) is measurement of the average size of platelets.