hemato-lymphoid system - ju medicine · 2020. 10. 21. · * poikilocytosis : abnormal shapes of...
TRANSCRIPT
![Page 1: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/1.jpg)
Hemato-lymphoid system
Practical Part
Edited by : Mohammad Alsayed
Dr. Heba Kalbouneh
Associate Professor of Anatomy and Histology
![Page 2: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/2.jpg)
Blood
![Page 3: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/3.jpg)
Erythrocytes
![Page 4: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/4.jpg)
1) This is a blood film (smear) showing erythrocytes , as you can see these cells are rounded with
acidophilic cytoplasm , the center area is likely stained (pale) because of the shape of these cells
(biconcave shape) .
So at center there is less amount of hemoglobin less acidophilic .
This center area occupies 1/3 of the cell volume (1/3 of its diameter) and this the normal
erythrocytes (normochromic erythrocytes) .
2) If you take a blood film and you see rounded red blood cells but without center pale area this
indicates that these cells are spherical in shape ( Spherocytes ) , and these cells contain more
hemoglobin than normal in relation to the cell volume so we call them (hyperchromic erythrocytes)
3) If you take a blood film and you see that the cells have pale area in the center but this area is
enlarged "more than 1/3 of cell volume" , we call these cells
(hypochromic erythrocytes) because they have lesser amount of hemoglobin .
- We have abnormal shapes of erythrocytes like (sickle cells , poikilocytes "tear drop shape" ,
ovalocytes) and we call the condition that we have abnormal shapes of RBCs (Poikilocytosis) .
![Page 5: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/5.jpg)
1) The normal size of RBCs is between 6-9 µm in diameter Normocytic erythrocytes
2) If you take blood film and see all erythrocytes are smaller than 6 µm Microcytic
erythrocytes
3) If you take blood film and see all erythrocytes are more than 9 µm Macrocytic
erythrocytes
4) If you take blood film and see different sizes of erythrocytes Anisocytosis
* Anisocytosis : different sizes of RBCs
* Poikilocytosis : abnormal shapes of RBCs .
![Page 6: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/6.jpg)
Neutrophils
This shows a neutrophil
in a blood smear. The
neutrophils are 12-14
µm diameter, and so
look bigger than the
surrounding red blood
cells. There is a single
nucleus, which is
multilobed, and can
have between 2 and 5
lobes , and cytoplasm
contains tiny small
granules that stained
light pink or light purple
- These cells are the most common type of
WBCs in peripheral blood .
- Mainly they identified by their multilobed
nucleus .
- Neutrophils are the first WBCs to leave
the bloodstream and enter the connective
tissue in large numbers . - They involved in acute infections and
acute inflammation (especially during
bacterial infections) .
![Page 7: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/7.jpg)
This shows an eosinophil in a blood
smear. You can see that eosinophil has
a bilobed nucleus.
These cells have large acidophilic
specific granules - these stain
bright red, or reddish-purple.
They involved in parasitic
infections .
Eosinophils
s
![Page 8: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/8.jpg)
This shows a basophil in a blood
smear . The basophil contains lots
of deep blue staining granules
(basic) and a bilobed irregular
nucleus (S shape) , that is often
difficult to see .
Mainly involved in allergic
reactions .
Basophils
![Page 9: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/9.jpg)
Lymphocytes This shows lymphocytes in a blood smear.
Most of the lymphocytes are small; a bit bigger
than red blood cells, at about 6-9µm in diameter.
Lymphocyte has a small spherical nucleus with
dark staining condensed chromatin. Not much
cytoplasm can be seen, and it is basophilic
(pale blue/purple staining).
Under the light microscope , we can NOT
differentiate between the B and T lymphocytes
"same morphology"
![Page 10: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/10.jpg)
Large lymphocyte
Small lymphoc
The rest of lymphocytes (around 10%) are larger. These larger cells have
more cytoplasm and more euchromatic nucleus. Larger lymphocytes are
commonly activated lymphocytes
- Large amount of
cytoplasm
- more euchromatic
nucleus
- Little amount of cytoplasm
- Large heterochromatic
nucleus
![Page 11: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/11.jpg)
This shows a monocyte in a blood smear.
Monocytes are the largest type of white blood
cells, and can be up to 20µm in diameter. They have
a large eccentrically placed nucleus, which is C or
kidney bean shaped. They have abundant
cytoplasm, and some fine purple granules in
cytoplasm (frosted glass appearance).
Monocytes
During infection , these cells are the last cells to leave the blood
stream and enter connective tissue and become macrophage that
phagocytose (the dead cells , the dead bacteria and Ag-Ab complex)
![Page 12: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/12.jpg)
Platelets Under LM : They appear in
clumps because they have thick
glycocalyx , this facilitate their
aggregation .
Under EM : They divided into
2 zones :
- Outer zone (hyalomere) : contain
microtubules + microfilaments
- Inner zone (granulomere) :
contain lots of granules .
we have many types of granules
and they contain mediators
involved in blood clot formation .
![Page 13: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/13.jpg)
Identify
![Page 14: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/14.jpg)
Neutrophil
Eosinophil
Small lymphocyte
![Page 15: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/15.jpg)
Neutrophil
Large lymphocyte
![Page 16: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/16.jpg)
Neutrophil
![Page 17: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/17.jpg)
Small lymphocyte
Large lymphocyte
![Page 18: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/18.jpg)
Eosinophil
![Page 19: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/19.jpg)
Monocyte
These are azurophilic non specific granules not specific granules
![Page 20: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/20.jpg)
Basophil
![Page 21: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/21.jpg)
Basophil
Neutrophil
![Page 22: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/22.jpg)
Monocyte
Platelets
![Page 23: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/23.jpg)
Platelets
![Page 24: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/24.jpg)
Don’t Worry, Be Happy!
![Page 25: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/25.jpg)
Bone marrow
Red bone marrow consists of hematopoietic cords (blood forming cells) and blood sinusoids
supported by a reticular tissue.
While yellow bone marrow consists mainly of adipocytes
![Page 26: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/26.jpg)
![Page 27: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/27.jpg)
Band cell
(Neutrophil) Basophilic myelocyte
Polychromatophilic
erythroblast
Proerythroblast Mature
erythrocytes
Neutrophilic
metamyelocyte
Eosinophilic
metamyelocyte
Eosinophilic
myelocyte
Mature Eosinophil
Mature
neutrophil
Neutrophilic
myelocyte
Normoblast
Basophilic
erythroblast
Megakaryocyte Platelets
Red Bone Marrow (Giemsa stain)
Dr.
Heb
a K
alb
ou
neh
![Page 28: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/28.jpg)
Polychromatophilic
erythroblasts
Normoblasts Megakaryocte
Sinusoid
Adipocyte
Myelocyte
Metamyelocyte
Basophilic
erythroblast
Reticular cell
Eosinophilic
Myelocyte
Red Bone Marrow (H&E)
Dr.
Heb
a K
alb
ou
neh
![Page 29: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/29.jpg)
Red Bone Marrow
H&E
Low magnification
Hematopoietic cords
Adipocytes
Trabeculae of
spongy bone
Dr.
Heb
a K
alb
ou
neh
![Page 30: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/30.jpg)
Yellow Bone Marrow
H&E
Low magnification
Trabeculae of
spongy bone
Adipocytes
Dr.
Heb
a K
alb
ou
neh
![Page 31: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/31.jpg)
Thymus
Note that the gland is organized into numerous lobules.
Each lobule contains a dark-staining outer cortex and
inner medulla. Also note the capsule that extends into
the thymus to form the interlobular septa (trabeculae)
that separate the lobules. The capsule and septa contain
blood vessels, lymphatics and nerves.
Note also that thymus has no lymphoid follicles
![Page 32: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/32.jpg)
Cortex
Capsule
Medulla
Hassall
corpuscle Lobule
Trabecula
Dr.
Heb
a K
alb
ou
neh
Dense connective tissue
Precursor cells for T lymphocytes migrate from bone
marrow , enter the thymus and populate mainly in outer
part of lobule (cortex)
They go different stages of development and
differentiation , thymic education and training and
move toward the medulla and end up with mature T
cells ready to leave the thymus and enter bloodstream .
specific for inner medulla,
composed of flat epithelial
cells with a core of
keratinization. There are
thymic epithelial cells inside
cortex and medulla with
many processes, connected
by desmosomes, and they
protect the developing T
cells during their thymic
education.
![Page 33: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/33.jpg)
Capsule
Medulla
Hassall
corpuscles
Lobule
Trabeculae
Thymus
H&E
Low magnification
Cortex
Dr.
Heb
a K
alb
ou
neh
![Page 34: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/34.jpg)
Cortex
Trabeculae Medulla
Lobule
Capsule
Thymus
H&E
Low magnification
Dr.
Heb
a K
alb
ou
neh
![Page 35: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/35.jpg)
Hassall
Corpuscle in medulla
Thymic medulla
H&E
High magnification
Dr.
Heb
a K
alb
ou
neh
![Page 36: Hemato-lymphoid system - JU Medicine · 2020. 10. 21. · * Poikilocytosis : abnormal shapes of RBCs . Neutrophils This shows a neutrophil in a blood smear. The neutrophils are 12-14](https://reader033.vdocuments.mx/reader033/viewer/2022053118/609bc404c7da9a56a80225e8/html5/thumbnails/36.jpg)
Involution in Thymus
H&E
Low magnification
Dr.
Heb
a K
alb
ou
neh
In this section we can see high
numbers of fat cells inside thymic
tissue and deposition of fat takes place
in thymus after puberty time , the
thymus start to shrink in size and
replaced by fatty tissue and we call
this (Involution in Thymus)