RT Journal
A1 Wortman J
T1 ARtifacts in peripheral blood films
JF JAMA
JO JAMA
YR 1979
FD February 23
VO 241
IS 8
SP 792
OP 792
DO 10.1001/jama.1979.03290340016014
UL http://dx.doi.org/10.1001/jama.1979.03290340016014
AB To the Editor.— 
    Microscopic examination of the peripheral blood has long been recognized as an important part in patient evaluation. Useful information can be obtained regarding all of the formed elements of the blood, thus making it fundamental to the hematologic evaluation of any patient.However, artifacts frequently may be present to perplex the examiner. The more common ones may appear in parts of every peripheral blood film.' One seemingly ominous finding involves clusters of immature-appearing cells resembling blastocytes or metastatic tumor cells observed when the blood film is prepared from the first drop of blood from the traditional finger wound.We recently encountered a patient with such a finding. The patient was an elderly man admitted to our facility for control of congestive heart failure. On routine evaluation of his peripheral blood smears, the patient was found to have several distinct clumps of immature-appearing cells (Figure). This finding caused