Imaging session Haematology MBChB V. Session 1 MJ Coetzee. Normal blood picture. Normal blood smear. Normal white cells. Normal red cells & platelets. Eosinophil. Basophil. Normal band cell. Normal bone marrow.
Imaging sessionHaematologyMBChB V
Session 1MJ Coetzee
Normal blood picture
Normal white cells
Normal red cells& platelets
Normal bone marrow
Normal bone marrow particle (1/3 adipose cells)
Biopsy (histological picture)
Particle on smear
Hypocellular bone marrow
Adipose cells have replaced normal bone marrow
Full blood count
Red cell shapes
Oval macrocytes (e.g. megaloblastic anaemia
Rouleaux (e.g. TB, HIV)
Spherocytes: blood smear
Shape of normal RBCs & spherocytes
Common white cell disorders
Band cell (left shift)
Döhle bodies (infection)
Leucoerythroblastic anaemia:White cell & red blood cell precursors
Leucoerythroblasticanemia:bone marrow infiltrate by cancer cells
The leucocyte in viral infection:reactive lymphocytes
Loose nuclear fragments
Acid-fast bacilli in bone marrow (TB)
Non-falciparum malaria (large cells)
Geographic distribution malaria- and haemoglobinopathies
“Strawberry” tongue:Fe deficiency
Hands useful, regardless of ethnicity
Fe deficiency: spoon nails
Hypochromic microcytic RBCs
No Fe stainin marrow particle
Normal (blue) Fe stain of marrow particle
Gastrointestinal bleed because of cancer(Ba contrast)
Vit B12 deficiency: demyelinisation
Jaundice of haemolysis
Warm (IgG) AIHA:pherocytosis, polychromasia, normoblasts
Cold (IgM) autoimmune haemolytic anaemia: agglutination
Macroscopic agglutination in tube
Gall stones after chronic haemolysis (barium in gall bladder)
Aplastic anaemia:purpura ofthrombocytopenia
Describe the red cells please.
What are these red cells called?
What are the causes of this red cell phenomenon?
What is the naem of this haemoglobinopathy?
What is the single cause of all these red cell changes?
Paper case 1
T. is an 18-year old woman that has become increasingly pale and tired over the last fortnight. Her eyes are yellow. Her left upper abdomen is tender. Her mother had a similar condition as a youngster and had a splenectomy. After the operation her mother’s symptoms never recurred. T’s FBC shows the following: WBCs 7 x 109/l, haemoglobin 8 g/dl and platelets 250 x 109/l. Her blood smear shows spherocytes and her reticulocyte count is raised.