{"schema":"https://ver.cy/schemas/card/1.0.0","id":"vr.tr.metamyelocyte","code":"thing-q3299749","url":"https://ver.cy/models/thing/q3299749/","name":"metamyelocyte","alternateNames":["eosinophilic metamyelocyte","neutrophilic metamyelocyte","basophilic metamyelocyte"],"kind":"thing","status":"published","version":"0.1.0-research.1","language":"en","classifiers":{"family":"Thing Registry","category":"Physical world and living systems","entryKind":"thing","plane":"PHY","domain":["PHY.OBJ"],"industry":[],"navPath":"","tags":[],"facets":{}},"whatItIs":"A metamyelocyte is a postmitotic, immature granulocyte that develops from a myelocyte and has lineage-specific cytoplasmic granules and an indented, typically kidney-shaped nucleus.","purpose":"Enable an agent to recognize a metamyelocyte, record evidence for its granulocytic maturation stage, and determine whether its identification and specimen context require further review.","scope":{"in":["Recognition of the metamyelocyte stage within granulocytic maturation","Neutrophilic, eosinophilic, basophilic or unresolved lineage attribution","Nuclear indentation, chromatin and cytoplasmic granulation","Cell-level observations linked to marrow, blood or experimental specimens","Stage-specific counting, classification confidence and review decisions"],"out":["The complete granulopoiesis process and its systemic regulation","Myelocytes, band granulocytes and segmented granulocytes as independently modeled stages","Monocyte development and identification beyond differential exclusion","Whole-patient diagnosis, prognosis and treatment selection","Laboratory instruments, staining reagents and specimen collection procedures","Complete blood-count interpretation and population reference-interval maintenance"],"boundaries":[]},"distinguishingFeatures":["For a human neutrophilic candidate, assess an indented, unsegmented nucleus with condensed chromatin; the ASH example describes indentation less than half the nuclear diameter. Record the convention used at the band-cell boundary. [ASH metamyelocyte](https://imagebank.hematology.org/image/60398/metamyelocyte)","Against a myelocyte candidate, require evidence that the nuclear contour has entered the indented metamyelocyte stage under the applicable morphology convention.","Against a segmented granulocyte, check for absence of distinct nuclear lobes connected by thin filaments.","Against a monocyte or earlier granulocytic precursor, evaluate chromatin and lineage-compatible granulation together with nuclear contour; a kidney-shaped outline alone is insufficient.","Treat metamyelocyte as a maturation-stage identity rather than a synonym for neutrophil lineage: the broader granulocyte precursor category includes neutrophilic, eosinophilic and basophilic development. [NCBI MeSH: Granulocyte Precursor Cells](https://www.ncbi.nlm.nih.gov/mesh/D042381)"],"structure":{"bundles":[{"id":"stage-and-lineage","name":"Stage and lineage","description":"Establish what the metamyelocyte label identifies and how lineage qualifies it.","layers":[{"id":"stage-boundaries","name":"Stage boundaries","description":"Locate the candidate between neighboring granulocytic stages.","findings":[{"id":"metamyelocyte-stage-assignment","name":"Metamyelocyte stage assignment","description":"Require an explicit staging convention and record competing assignments near the myelocyte and band boundaries.","questions":[{"text":"Which morphological criteria establish the metamyelocyte stage in the applicable species and lineage?","id":"metamyelocyte-stage-assignment-q01","kind":"definition"},{"text":"Which observed feature excludes a myelocyte or band-cell assignment, and where does ambiguity remain?","id":"metamyelocyte-stage-assignment-q02","kind":"boundary"}]}]},{"id":"lineage-attribution","name":"Lineage attribution","description":"Distinguish maturation-stage evidence from evidence for granulocyte lineage.","findings":[{"id":"granulocyte-lineage-evidence","name":"Granulocyte lineage evidence","description":"Record the lineage supported by granulation and any additional evidence, retaining unresolved cases.","questions":[{"text":"Which granule features support neutrophilic, eosinophilic or basophilic attribution under this stain?","id":"granulocyte-lineage-evidence-q01","kind":"definition"},{"text":"Can the stage be identified while lineage remains unresolved, and how should that result be represented?","id":"granulocyte-lineage-evidence-q02","kind":"boundary"}]}]}]},{"id":"morphological-recognition","name":"Morphological recognition","description":"Capture the visible features needed to recognize and challenge a metamyelocyte identification.","layers":[{"id":"nuclear-morphology","name":"Nuclear morphology","description":"Assess indentation, segmentation and chromatin as separate observations.","findings":[{"id":"indentation-and-chromatin","name":"Indentation and chromatin","description":"The ASH neutrophilic example supports recording shallow nuclear indentation and condensed chromatin together. [ASH metamyelocyte](https://imagebank.hematology.org/image/60398/metamyelocyte)","questions":[{"text":"How are indentation depth and its reference nuclear dimension defined and measured?","id":"indentation-and-chromatin-q01","kind":"measurement"},{"text":"Do segmentation and chromatin support the assigned stage, or suggest a competing cell identity?","id":"indentation-and-chromatin-q02","kind":"boundary"}]}]},{"id":"cytoplasmic-morphology","name":"Cytoplasmic morphology","description":"Record lineage-compatible granulation, cytoplasmic appearance and cell dimensions.","findings":[{"id":"granulation-and-cell-proportions","name":"Granulation and cell proportions","description":"Preserve granule appearance and calibrated dimensions as evidence rather than relying on the nuclear silhouette alone.","questions":[{"text":"What granule color, abundance and distribution are visible under the recorded staining conditions?","id":"granulation-and-cell-proportions-q01","kind":"measurement"},{"text":"Which cytoplasmic and nuclear features distinguish this candidate from a monocyte or earlier granulocytic precursor?","id":"granulation-and-cell-proportions-q02","kind":"boundary"}]}]}]},{"id":"maturation-and-cell-state","name":"Maturation and cell state","description":"Relate the stage assignment to developmental progression while separating expected biology from observed state.","layers":[{"id":"developmental-relations","name":"Developmental relations","description":"Connect the stage to its precursor and subsequent maturation stages.","findings":[{"id":"maturation-sequence-evidence","name":"Maturation sequence evidence","description":"Represent predecessor and successor relationships with species and lineage qualifications.","questions":[{"text":"Which precursor and successor stages are recognized for this lineage under the chosen nomenclature?","id":"maturation-sequence-evidence-q01","kind":"definition"},{"text":"Is the developmental relationship inferred from morphology or supported by lineage tracing or serial observation?","id":"maturation-sequence-evidence-q02","kind":"provenance"}]}]},{"id":"proliferation-and-integrity","name":"Proliferation and integrity","description":"Keep cell-cycle expectations and integrity observations separate from stage classification.","findings":[{"id":"stage-state-discordance","name":"Stage-state discordance","description":"Make apparent division, degeneration or assay evidence that conflicts with the stage assignment reviewable.","questions":[{"text":"What evidence establishes the proliferation status expected at this stage, and was proliferation measured in this cell?","id":"stage-state-discordance-q01","kind":"provenance"},{"text":"Should apparent mitosis or severe degeneration trigger reclassification, an uncertainty flag or specialist review?","id":"stage-state-discordance-q02","kind":"action"}]}]}]},{"id":"specimen-occurrence-and-counting","name":"Specimen occurrence and counting","description":"Connect individual metamyelocytes to their anatomical compartment and specimen-level abundance.","layers":[{"id":"compartment-context","name":"Compartment context","description":"Interpret occurrence in relation to specimen origin and organism context.","findings":[{"id":"marrow-versus-circulation","name":"Marrow versus circulation","description":"ASH describes peripheral-blood metamyelocytes in several reactive and neoplastic settings; occurrence alone therefore does not identify a cause. [ASH metamyelocyte](https://imagebank.hematology.org/image/60398/metamyelocyte)","questions":[{"text":"Was the cell observed in marrow, peripheral blood, another tissue or culture, and how was that origin established?","id":"marrow-versus-circulation-q01","kind":"provenance"},{"text":"Which species-, age- and specimen-specific expectations determine whether its occurrence needs review?","id":"marrow-versus-circulation-q02","kind":"boundary"}]}]},{"id":"differential-enumeration","name":"Differential enumeration","description":"Represent stage-specific counts without conflating them with broader immature-granulocyte categories.","findings":[{"id":"count-denominator-and-category","name":"Count denominator and category","description":"Link counted metamyelocytes to the counting method, total examined population and laboratory category definition.","questions":[{"text":"How many metamyelocytes were identified among how many cells, and what population forms the denominator?","id":"count-denominator-and-category-q01","kind":"measurement"},{"text":"Does the reported immature-granulocyte result resolve metamyelocytes separately or combine several maturation stages?","id":"count-denominator-and-category-q02","kind":"boundary"}]}]}]},{"id":"identification-quality-and-review","name":"Identification quality and review","description":"Preserve the evidence and limitations governing acceptance of a metamyelocyte label.","layers":[{"id":"observation-quality","name":"Observation quality","description":"Assess whether preparation and imaging permit reliable evaluation of stage-defining features.","findings":[{"id":"assessability-of-stage-features","name":"Assessability of stage features","description":"Record whether nuclear contour, chromatin and granules remain interpretable despite overlap, distortion or staining limitations.","questions":[{"text":"Which preparation, stain, image calibration and cell image support this identification?","id":"assessability-of-stage-features-q01","kind":"provenance"},{"text":"Are artifacts severe enough to prevent assessment of indentation, segmentation or granulation?","id":"assessability-of-stage-features-q02","kind":"measurement"}]}]},{"id":"classification-resolution","name":"Classification resolution","description":"Resolve uncertain or discordant stage assignments through documented review.","findings":[{"id":"reviewable-stage-decision","name":"Reviewable stage decision","description":"Retain the initial label, alternative classifications and the basis of any reviewer correction.","questions":[{"text":"Which alternative cell identities remain plausible, and what evidence would resolve them?","id":"reviewable-stage-decision-q01","kind":"boundary"},{"text":"Should the agent accept the label, request another image or route the cell for qualified morphology review?","id":"reviewable-stage-decision-q02","kind":"action"}]}]}]},{"id":"evidence-and-external-alignment","name":"Evidence and external alignment","description":"What the world already says about this thing, gathered so the model can be checked against it.","layers":[{"id":"reported-evidence","name":"Reported evidence","description":"Findings from the breadth pass, kept separate from the structural claims.","findings":[{"id":"evidence-confidence-notes","name":"Check these first","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these check these first hold for the sense of metamyelocyte this model covers, and on what evidence?","id":"evidence-confidence-notes-q01","kind":"provenance"}]},{"id":"evidence-kinds","name":"Kinds and varieties","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these kinds and varieties hold for the sense of metamyelocyte this model covers, and on what evidence?","id":"evidence-kinds-q01","kind":"provenance"}]},{"id":"evidence-real-world-use","name":"Real-world use","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these real-world use hold for the sense of metamyelocyte this model covers, and on what evidence?","id":"evidence-real-world-use-q01","kind":"provenance"}]},{"id":"evidence-measurements","name":"Typical measurements","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these typical measurements hold for the sense of metamyelocyte this model covers, and on what evidence?","id":"evidence-measurements-q01","kind":"provenance"}]},{"id":"evidence-failure-modes-and-hazards","name":"Failure modes and hazards","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these failure modes and hazards hold for the sense of metamyelocyte this model covers, and on what evidence?","id":"evidence-failure-modes-and-hazards-q01","kind":"provenance"}]},{"id":"evidence-neighbours","name":"Neighbouring kinds and how to tell them apart","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these neighbouring kinds and how to tell them apart hold for the sense of metamyelocyte this model covers, and on what evidence?","id":"evidence-neighbours-q01","kind":"provenance"}]}]}]}]},"agentConduct":{"may":["Explain what a metamyelocyte is and where it appears in blood cell development.","Flag reported metamyelocyte counts on a blood test for clinician review."],"mustNot":["Diagnose a disease such as leukaemia or infection from a metamyelocyte count.","Tell a patient that a result is normal or abnormal in place of their clinician.","Share a patient's blood results without consent."],"requiresHuman":["Any clinical decision that follows from a blood film result."]},"ethics":{"considerations":["Abnormal blood results can frighten patients; they must hear them from a clinician.","Blood test data are private health information."],"affectedParties":["Patients","Clinicians"]},"owners":{"steward":"Nobody owns the cell type; the laboratory and treating clinician answer for each result.","roles":[],"masterSystems":[]},"relations":[{"target":"Q66590180","type":"parent","note":"registry parent class"},{"target":"Q7868","type":"parent","note":"registry parent class"}],"interaction":{"identity":{"applicability":"required","items":["Vercy registry: vr.tr.metamyelocyte","Wikidata: Q3299749 (https://www.wikidata.org/wiki/Q3299749)"]},"properties":{"applicability":"required","items":["Granulocytic lineage: neutrophilic | eosinophilic | basophilic | unresolved","Species and developmental context: Link to organism species and age or developmental category","Nuclear indentation: Indentation depth divided by the explicitly defined nuclear reference dimension; dimensionless","Nuclear architecture: Contour description; segmentation absent | present | unresolved; chromatin condensed | intermediate | fine | unassessable","Cytoplasmic granulation: Granule color, coarseness, abundance and distribution under a named stain","Observed cell diameter: µm, with calibration and measurement method","Specimen compartment: Link to bone marrow | peripheral blood | other tissue | experimental culture specimen","Identification status: candidate | reviewer-confirmed | disputed | unclassifiable","Specimen-level abundance: Observed cell count; percentage with named denominator; cells/µL only when validly derived"]},"recognition":{"applicability":"required","items":["The nucleus is indented or kidney-shaped and lacks the distinct lobes of a segmented granulocyte.","Nuclear chromatin is condensed and nucleoli are generally not visible.","The cytoplasm contains lineage-specific granules that help distinguish granulocytic maturation from other cell lineages.","The nuclear indentation is typically shallower than that of a band granulocyte."]},"capabilities":{"applicability":"required","items":["Annotate a cell image with the nuclear and cytoplasmic evidence supporting metamyelocyte identification.","Compare a candidate with myelocyte, band granulocyte, segmented granulocyte and monocyte alternatives.","Assign a granulocytic lineage or retain an unresolved attribution.","Include a reviewed identification in a specimen differential with an explicit denominator.","Flag ambiguous staging, discordant morphology or specimen occurrence for qualified review.","Link repeated observations to a maturation experiment without inferring cell history from one fixed image."]},"hazards":{"applicability":"required","items":["Confusion with myelocytes or band granulocytes can distort differential counts and maturation assessments.","Treating the presence of metamyelocytes as diagnostic by itself can lead to unsupported clinical conclusions.","Poor specimen preservation or staining can obscure morphology and produce incorrect classification.","Blood and bone marrow specimens can expose handlers to biological hazards."]},"interfaces":{"applicability":"required","items":["ISO 15189, issued by the International Organization for Standardization, specifies quality and competence requirements for medical laboratories performing examinations such as blood cell morphology assessment."]},"context":{"applicability":"required","items":["Metamyelocytes are encountered during examination of bone marrow as a normal stage of granulocyte maturation.","Their identification in peripheral blood contributes to assessment of immature granulocyte release and requires interpretation alongside the specimen and clinical context."]}},"sources":[{"title":"Wikidata item Q3299749: metamyelocyte","url":"https://www.wikidata.org/wiki/Q3299749","note":"identity and sense of the item"},{"title":"Wikipedia: Metamyelocyte","url":"https://en.wikipedia.org/wiki/Metamyelocyte","note":"general description of the item"}],"openQuestions":["Which authoritative staging conventions should govern indentation measurements and borderline myelocyte-metamyelocyte-band assignments?","How should recognition criteria vary across neutrophilic, eosinophilic and basophilic metamyelocytes and across species?","Which validated size distributions and specimen-occurrence expectations apply to the intended species, age groups and preparation methods?","Which assays independently support maturation and proliferation-state attribution, and how should disagreement with morphology be represented?","Which laboratory review rules and automated differential definitions permit a metamyelocyte-specific result rather than a combined immature-granulocyte category?"],"resources":{"spec":"/models/things/publications/thing-q3299749/spec.json"},"provenance":{"origin":"thing registry research (pass 2)","builtFrom":["models/things/publications/thing-q3299749/spec.json"],"providers":["Codex"],"researchStatus":"unreviewed","generatedAt":"2026-09-12T11:16:22Z","builder":"tools/build_cards.py@1.0.0"},"completeness":{"sections":{"classifiers":"filled","whatItIs":"filled","purpose":"filled","distinguishingFeatures":"filled","structure":"filled","agentConduct":"filled","ethics":"filled","owners":"filled","relations":"filled","interaction.identity":"filled","interaction.properties":"filled","interaction.recognition":"filled","interaction.capabilities":"filled","interaction.hazards":"filled","interaction.interfaces":"filled","interaction.context":"filled","sources":"filled"},"notes":{"_gate":"Published through the thing publication gate 1.0 on 2026-10-07T10:10:30+00:00: completeness 1.00; sense: Wikidata description; 2 live sources; review by codex: pass"},"score":1.0}}