Transcript Hematopathology

Hematopathology
This is the appearance of normal bone marrow at medium
magnification. Note the presence of megakaryocytes, erythroid
islands, and granulocytic precursors. This marrow is taken from the
posterior iliac crest in a middle aged person, so it is about 50%
cellular, with fatty tissue admixed with the marrow elements.
• This is the appearance of normal bone marrow at high
magnification. Note the presence of megakaryocytes, erythroid
islands, and granulocytic precursors. This marrow is taken from the
posterior iliac crest in a middle aged person, so it is about 50%
cellular, with steatocytes admixed with the marrow elements.
• This is the appearance of normal bone marrow smear at
high magnification. Note the presence of
megakaryocytes, erythroid precursors, and granulocytic
precursors.
Erythroblasts
or normoblasts
Microscopical
Features:
Reticulocyte
Proerythoblast
Early
intermediate
late
•Reduction in the cell size.
•Loss of nucleoli.
Mature
•Clumping of nuclear chromatin.
RBC
•Hemoglobinization of the
cytoplasm.
•Loss of nuclei.
Proerythoblast
Normoblasts
Intermediate
Late
Red Cell precursors (in marrow)
Microscopical
Features:
Stages of Maturation of the
Granulocytic
Series
•Reduction
in the cell size.
In the bone
marrow
•Loss of nucleoli.
•Granulation of cytoplasm
( primary and secondary).
•Nuclear segmentation.
Bone marrow
Blood
Blood leucocyte morphology
1.Neutrophils
• They are also
leukocytes.
known
as
polymorphonuclear
• They have a multilobed nucleus which may appear
like
multiple
nuclei,
hence
the
name
polymorphonuclear leukocyte.
• The cytoplasm may look transparent because of fine
granules that are faintly pink in color.
Function of Neutrophil
• Neutrophils defend against bacterial or fungal infection and
other very small inflammatory processes that are usually first
responders to microbial infection & they are are very active in
phagocytosing bacteria & are present in large amount in the
pus of wounds.
•
Their activity and death in large numbers forms pus.
• These cells are not able to renew their lysosomes used in
digesting microbes and die after having phagocytosed a few
pathogens
2.Eosinophil
• Generally their nucleus is bi-lobed. The cytoplasm is full of
granules which assume a characteristic pink-orange color with
eosin stain.
Function:
• Eosinophils primarily deal with parasitic infections .
• Eosinophils are also the predominant inflammatory cells in
allergic reactions.
3. Basophils
• The nucleus is bi- or tri-lobed, but it is hard to see
because of the number of coarse granules which hide
it.
• They are characterised by their large blue granules.
Function:
• Basophils are chiefly responsible for allergic and
antigen response by releasing the chemical histamine
causing inflammation.
4. Lymphocyte
• Lymphocytes are much more common in the lymphatic
system.
• Lymphocytes are distinguished by having a deeply staining
nucleus which may be eccentric in location.
• B cells make antibodies that bind to pathogens to enable their
destruction.
• CD4+ (helper) T cells co-ordinate the immune response and
are important in the defense against intracellular bacteria. In
acute HIV infection, these T cells are the main index to
identify the individual's immune system activity.
• CD8+ cytotoxic T cells are able to kill virus-infected and
tumor cells. CD8+ cells are also another index to identify
human's immune activity.
Monocyte 5.
• They have the kidney shaped nucleus and are
typically agranulated. They also possess abundant
cytoplasm.
Function:
• Monocytes
share
the
"vacuum
(phagocytosis) function of neutrophils
cleaner"
• Monocytes eventually leave the bloodstream to
become tissue macrophages which remove dead cell
debris as well as attacking microorganisms.
Megakaryocyte : the precursor of Platelets in
the marrow
Microscopical Features:
•Increased cell size.
•Lobulation of the nuclei.
•Cytoplasmic granulation.
• The red blood cells here are normal, happy RBC's. They have a
zone of central pallor about 1/3 the size of the RBC. The RBC's
demonstrate minimal variation in size (anisocytosis) and shape
(poikilocytosis). A few small blue platelets are seen. In the center of
the field are a band neutrophil on the left and a segmented
neutrophil on the right.
• A normal mature lymphocyte is seen on the left
compared to a segmented PMN on the right. An
RBC is seen to be about 2/3 the size of a
normal lymphocyte.
• Here is a monocyte. It is slightly larger than a lymphocyte and has a
folded nucleus. Monocytes can migrate out of the bloodstream and
become tissue macrophages under the influence of cytokines. Note
the many small smudgy blue platelets between the RBC's
• In the center of the field is an eosinophil with a bilobed nucleus
and numerous reddish granules in the cytoplasm. Just
underneath it is a small lymphocyte. Eosinophils can increase
with allergic reactions and with parasitic infestations
• There is a basophil in the center of the field which has a lobed
nucleus (like PMN's) and numerous coarse, dark blue granules in
the cytoplasm. They are infrequent in a normal peripheral blood
smear, and their significance is uncertain. A band neutrophil is
seen on the left, and a large, activated lymphocyte on the right.
White Blood Cells