1. blood cell morphology

8/12/2019 1. Blood Cell Morphology

1/150

BLOOD

CELL

MORPHOLOGY


2/150


3/150


4/150


5/150

BLOOD

RESPIRATION

INFECTION BLEEDING

NUTRITION

JAWHAR AL HAYAT


6/150

ERYTHROPOIESIS


7/150

ERYTHROPOIESIS


8/150

Blood Cells

RBC Red Blood CellsWBC White Blood CellsPlatelets


9/150

Blood Cells

RBCWBC Platelets


10/150

BLOOD

8% OF TOTAL BODY WEIGHT

HEMOPOIESIS:

*ERYTHROPOIESIS

**MYELOPOIESIS

***PLATELET PRODUCTION45%

55%


11/150

HEMOPOIESISMYELOID/ LYMPHOID

STEM CELLS

(CD34)

LYMPHOIDSTEM CELLS

MYELOIDSTEM CELLS

LYMPHOCYTES RBC WBC PLATELET


12/150


STEM CELLS

(CD34)LYMPHOID

STEM CELLS

Pre-T

Thymocyte

Peripheral T Cells

T-Helper

T-Supp.

Pro-B

Pre-B

B Virgin

B Mature

LPC

PLASMACELL


13/150


STEM CELLS

(CD34)

MYELOIDSTEM CELLSRO-

NORMOBLASTEARLY

NORMOBLAST

INTERMEDIATENORMOBLAST

LATE

NORMOBLAST

RETICULOCYTE

RBC

MONO-BLAST

PROMONO-CYTE

MONO-CYTE

MYELOBLAST

PRO-MYELOCYTE

MYELOCYTE

META-MYELOCYTE

BAND or STAB

GRANULOCYTES

MEGA-KARYO-

CYTE

MEGA-KARYO-

BLAST

PLATELET


14/150

ERYTHROPOIESIS


15/150

ERYTHROPOIESIS

ProNB

EarlyNB

Inter.NB

LateNB Retic. RBC


16/150

PRO-NORMO-

BLAST

The earliest recognizableerythroid cell

Around 16 um in diameter Deep blue basophilic

cytoplasm surrounding alarge ROUND nucleus

The nucleus consists of anetwork of finelyreticulated chromatinstrands having a spongy

or stippled reddishpurple appearance Several nucleoli seen


17/150

Resembles Pronormoblastalthough it is smaller(10 to 16 um) and doesnot have nucleoli

The nuclear chromatinis condensed to form

coalescent clumps

EARLYor

BASOPHILIC

NORMOBLAST


18/150

Hemoglobin synthesisstarts at this stage &the cytoplasm takesboth acidic and basicstains giving it apolychromatic color

The average diameteris 10 um

The nucleus becomesprogressively smallerand stains deeply asthe chromatin becomesmore clumpy

INETRMEDIATEor

POLYCHROMATIC

NORMOBLAST


19/150

The cell is round & small

It measures 8 to 10 um

The nucleus becomessmaller, darker andstructureless. It moves tothe periphery (eccentric)prior to expulsion

The cytoplasm becomesincreasingly hemoglobinized

LATEor

ORTHOCHROMIC

NORMOBLAST


20/150

This poor young graduate of marrow school ofmedicine has to join the army and do sometraining in the spleen.

Spleen is red cells tough battle-field. Unfitsoldiers hardly make it out of the training camp

Fit Reticulocytes enter circulation as youngRBCs but still contain fine basophilic reticulumwhich stains bluish with Romanowsky stain andreticulated with supravital stain. After losingthis basophilic reticulum , they will develop toRBCs

RETICULOCYTE


21/150

0.2 to 2.0% of RBCsin Adult & Children(10,000 to 100,000/uL)

2.0 to 6.0% ininfants & cord blood

Remain in circulationas Reticulocytes for2 days

RETICULOCYTE


22/150

Fully-hemoglobinized,biconcave, flexible &squeezable hard-working

mature cells Life-span ~120 days Diameter ~8 um

Volume (MCV) 76-96 fL Hb (MCH) 27-32 pg

Stains deep at peripheryand pale in the center.This area of centralpallor is < one third ofdiameter.

RBC


23/150

Myelo-poiesis


24/150


25/150

Usually larger than MB!

Large ovoid purplenucleus with denserchromatin than MB and

fewer nucleoli Granules are large &

azurophilic

N/C ratio is 4/1

PROMYELOCYTE

Nucleoli: +Granules: +++


26/150

Round or Oval cellwith a round nucleus

Thick strands ofnuclear chromatin

Granules are eitherprimary azurophilicor secondaryspecific accordingto WBC type:

(Neutrophil,Eosinophil or

Basophil)

MYELOCYTE

Nucleoli: -Granules: +


27/150

Kidney-shapednucleus

Chromatin ismorecondensed

META-MYELOCYTE


28/150

Smaller cellswith a U-shapednucleus

Chromatin iscoarse andclumped

STAB or BANDFORM


29/150

Neutrophils havepink cytoplasmwith fine evenly-distributedneutrophilicgranules

2 to 5 nuclearsegments

Eosinophils &Basophils have bi-lobed nuclei &orange or deepblue granules

SEGMENTEDGRANULOCYTES


30/150

Differs from MB by:

Being slightlysmaller

Nucleus fills thecell

Fewer and lessdistinct

nucleoli

Lymphoblast


31/150

Small LC have a dark,dense, central, round,mature nucleus thatfills the cell & havesize of RBC

Large LC is double thesize with ample

cytoplasm & may be evengranules.

Lymphocytes

Children: Up to 9,000/uL

Adult: 1,500 to 4,000/uL


32/150

Elliptical fried-egglike cells with

eccentric nuclei The chromatin is very

dense & clumped Cytoplasm is deeply

basophilic with a paleperinuclear halo

Produces immunoglobulins


33/150

Differs from MB

by:Being biggerLighter cytoplasmLacey nuclear

chromatin

Nucleoli seen

Monoblast

s


34/150

Largest blood cells

Usually kidney-shaped nuclei withdelicate chromatin

Sky-blue cytoplasmwith occasionalvacuoles

Monocytes


35/150

Largest hemopoieticmarrow cells (~100um)

Multi-lobulatednuclei; no mitosisbut nuclearduplication

Abundant cytoplasmwith azurophilicgranules

Each Produces 3000platelets

Megakaryocytes

The committed platelet


36/150

MegakaryocytesThe committed platelet

progenitor cellsdo not undergoclassical mitosis;

instead they will developnuclear duplications &cytoplasmic expansion. Therapid increase in cytoplasm isaccommodated by progressive

folding, or invaginations, ofmegakaryocytic membrane. Thesedemarcation membranes willeventually produce individualplatelet membranes.

MK pseudopodia penetrates marrowsinusoids. Blood flow breaksoff large platelets that arefinally fragmented toindividual platelets in thepulmonary microcirculation .


37/150

Megakaryocytes

In stressedthrombopoiesis,cytoplasm maturesquicker thannucleus so that lowploidy MK start toproduce platelets

that are larger,denser andmetabolically moreactive

EACH MK CANPRODUCE 3000

PALETLETS


38/150

Tiny disc-shapedimportant cells

150,000 to 400,000/uL Life span: ~ 10 days MPV: 5 to 8 fL

Pct: 0.1 to 0.4%

Platelets


39/150

DIAGNOSTIC

TOOLSIN

HEMATOLOGY


40/150

DIAGNOSTIC TOOLSIN

HEMATOLOGYBLOOD SMEAR

MARROWTREPHINE BIOPSY

MARROWASPIRATION


41/150

Blood Smear SHEIKHA

Bone


42/150

BoneMarrow

Aspiration


43/150


44/150

BLOOD SMEAR


45/150


46/150

Normal Smear


47/150

NORMOCYTICNORMOCHROMIC

RED CELLS


48/150

PATHOLOGICAL RBC ABNORMALITIES

ANISO

CYTOSIS

Variation in sizeHigh RDW

Normal RDW 11.5 to 14.5%

ANISOCYTOSIS


49/150


POIKILO-CTOSIS

Variation in Shape

Poikilocytosis


50/150

APK


51/150

APK

SCSS CC

TTP


52/150

Normal Red Cells


53/150



54/150


SPHEROCYTOSIS


55/150



56/150


ELLIPTOCYTOSISor

OVALOCYTOSIS


57/150


58/150


STOMATOCYTOSIS


59/150



60/150


SickleCells


61/150



62/150


TargetCells


63/150


64/150


TeardropRed cells


65/150



66/150


67/150



68/150


BurrCells


69/150


Red cellsOn

FIRE


70/150


Acanthocytosis


71/150



72/150


HYPOCHROMICRED CELLS


73/150


74/150


Dimorphicred cells


75/150


BurrSpur

&

Acanthocytes


76/150



77/150


HOWELLJOLLY BODY


78/150


79/150


80/150


BASOPHILICSTIPPLING


81/150



82/150


RINGSIDEROBLASTS


83/150



84/150


SCHISTOCYTOSIS

MAHA


85/150

Acanthocytosis


86/150


87/150

Punctate Basophilia


88/150


89/150

Blister Cells


90/150


91/150

Lead Poisoning

Teardrop RBC &


92/150

Teardrop RBC &Punctate Basophilia


93/150

Ring Sideroblasts


94/150

Reticulocytosis


95/150


96/150

Sickle cells


97/150


98/150

Burr Cells


99/150


100/150

Dimorphic Blood Smear


101/150


102/150

Elliptocytosis


103/150

Burr Spur & Acanthocytes


104/150


105/150


106/150

Blister Red cells


107/150

Red Cells on Fire


108/150


109/150


110/150

T ll


111/150

Target cells

SHEIKHA


112/150

H h i C ll


113/150

Hypochromic Cells


114/150

HE


115/150

HE


116/150


117/150


118/150

HbH


119/150

HbH


120/150


121/150


122/150

Spherocytosis &


123/150

p ya Lymphocyte


124/150

Hypersegmentation


125/150

Hypersegmentation


126/150

Hypochromic


127/150

Microcytic RBCs


128/150

Fe


129/150

Fe

Megaloblastic Marrow


130/150

Megaloblastic Marrow


131/150

Intermediate Megaloblast


132/150

Intermediate Megaloblast

Polychromatic Megaloblasts


133/150

Polychromatic Megaloblasts

HJB in Megaloblastic Anemia


134/150

HJB in Megaloblastic Anemia

What is HJB?


135/150

What is HJB?


136/150

Neutrophil & Lymphocyte


137/150

Neutrophil & Lymphocyte


138/150

MYELOPOIESIS

Myelopoiesis


139/150

Myelopoiesis

Myeloblast


140/150

Myeloblast

Nucleoli


141/150

in Myeloblasts


142/150

Myeloblasts


143/150

Myeloblasts


144/150

Myeloblasts


145/150

Myeloblasts


146/150

Promyelocytes


147/150

Promyelocytes

Promyelocytes


148/150

Promyelocytes

FaggotCell

Myelocyte


149/150

Myelocyte


150/150

1. blood cell morphology

Documents