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Abnormal Blood Cell Morphology. Abnormal White Blood Cells. Neutrophils (AKA: PMNs, Polys, Segs ) Abnormalities in the neutrophil include….. Greater than 5% bands Hypersegmented nuclei (greater than 5 lobes) Toxic granulation Toxic vacuolization Dohle bodies

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Abnormal Blood Cell Morphology


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  1. Abnormal Blood Cell Morphology

  2. Abnormal White Blood Cells • Neutrophils (AKA: PMNs, Polys, Segs) • Abnormalities in the neutrophil include….. • Greater than 5% bands • Hypersegmented nuclei (greater than 5 lobes) • Toxic granulation • Toxic vacuolization • Dohle bodies • Younger stages than the band • When do you see them in high numbers? • Bacterial infections • Inflammation Norma l Toxic granulation, vacuolization, & Dohle bodies are seen during bacterial infections, burns, cancer, and toxic or inflammatory states. Hyper-segmented Dohle bodies Band Toxic granulation

  3. Abnormal White Blood Cells • Eosinophils (AKA: Eos) • Greater than 3% eosinophils is abnormal • When do you see them in high numbers? • parasitic infections • allergic reactions • Basophils • Greater than 1% is abnormal • When do you see them in high numbers? • allergic reactions • inflammatory reactions Normal Normal

  4. Abnormal White Blood Cells Normal • Monocyte • Greater than 10 % of WBCs in the blood is abnormal • When do you see them in high numbers? • bacterial infections • viral infections • Lymphocyte • Greater than 40% in the blood is abnormal • Some produce and secrete antibodies • Atypical forms are larger cells with round or irregular nucleus and abundant cytoplasm • When do you see them in high numbers? • viral infections • High and atypical form during infectious mononucleosis Normal

  5. Abnormal Platelets • Platelets (AKA: Thrombocytes or PLTs) • Formed from the fragments of a megakaryocyte • Megakaryocytes are found in the bone marrow • Megakaryocytes found in the peripheral blood are abnormal • Many giant platelets are abnormal • Abnormal platelets are • Larger than 3 micrometers in diameter • Giant thrombocytes or giant platelets are seen occasionally • Normal is between 7-20 per field • Decreased is <7 per field • Increased is >20 per field

  6. Abnormal Red Blood Cells • Red Blood Cells (AKA: Erythrocytes of RBCs) • Can be normal sized (oval or round) 6-8 micrometers in diameter= called normocytic • Can be smaller than normal <6 micrometers = called microcytic • Can be larger than normal >8 micrometers= called macrocytic • Anisocytosis is when they RBCs vary drastically in size • Poikilocytosis is when the RBCs vary drastically in shape • If the RBC color is normal = called normochromic • If the RBC color is decreased = called hypochromic (larger central pallor)

  7. Abnormal Red Blood Cells • Red Blood Cells (AKA: Erythrocytes of RBCs) • Can be compact RBCs, dark, dense, small = called spherocytes • Can be crescent shape and pointed = called sicklecells (depranocytes) • Can appear mouth-like = called stomatocytes • Can appear like ovals or elongated = called ovalocytes or elliptocytes • Can appear target shaped or bull’s eye = called targetcells (Codocytes)

  8. Abnormal Red Blood Cells • Red Blood Cells (AKA: Erythrocytes of RBCs) • Can be spiny = called acanthocytes • Fragmented cells is a broad category and includes many different types of cells. • Schistocytes (Keratocytes) and Helmetcells are examples of fragmented cells. • Nucleated RBCS usually found only in the bone marrow. Can be seen in the peripheral blood in severe anemia and in newborns.

  9. Abnormal Red Blood Cells • Common Red Blood Cell Inclusions • Howell-Jolly bodies • From left over DNA found in the RBC. • Appear as round, deep purple circles around 2 micrometers in diameter. • Found in patients after their spleen has been removed or when RBC production is rushed, pernicious anemia and hemolytic anemia. • Pappenheimer bodies • Small, light purple, beads, made from iron. • Located near the periphery of the RBC. • Need to be stained with Prussian blue to determine in they are true Pappenheimer bodies. • Seen in iron loading anemias and hereditary hemochromatosis.

  10. Abnormal Red Blood Cells • Common Red Blood Cell Inclusions • Basophillic stippling • Remains of RNA and mitochondia. • Diffuse granules found throughout the cytoplasm. • Found in patients that have fast RBC growth. • Found in patients with lead poisoning. • Heinz bodies • Denatured hemoglobin • Large 1-3 micrometers in diameter. • Located near the periphery of the RBC. • Special staining with a supravital stain is needed to visualize Heinz bodies. • Found in patients with G6PD deficiency and with some hemoglobinopathies.