eric1980

I agree with Auntie-D and your seniors on this, the slide hasn't properly dried prior to fixation. Bone marrow aspirates should be left to dry for at least an hour, the same with thick films for malarial parasites. The conclusion is reached through experience, the longer the drying the better.
Steve

Looks to me like the slides were stained while they were still damp. How long were the slides left to dry before staining. I've always recommended 30 minutes minimum (in my cell path days)

We report absolute and relative values on our automated diffs. The manual diff are reported in % only because that's the way it been done for years. Most docs like the % because they can remember the reference ranges and the relationship, ie: 70/30, 60/40. Our decision rules to perform a manual are based on the absolute values provided the cell populations are in typical positions. I personally don't believe that you should calculate absolute values for a manual diff based on only 100 counted cells. Jusy my "professional" opinion. I also find it interesting the most of our docs and nurses don't know how to calculate the ANC.

I would agree that while smudge cells are almost always the result of fragile lymphs, you cannot count them as such since you really do not know. Sometimes PMNs smudge also, they do look different from smudged lymphs.
Smudged lymphs are not unusual in CLL patients and sometimes young children. Some think that once smudge cells dissapear in a CLL smear, it means a worsening prognosis for the patient, as the tumor cells have become more robust.