1 / 47

LABORATORY DIAGNOSIS

LABORATORY DIAGNOSIS. RED BLOOD CELLS. PRONORMOBLAST. Size: 12-20 um Nucleus: round; nucleoli (1-2); fine chromatin Cytoplasm: dark blue N/C ratio: 8:1 Reference interval: BM: 1% PB: 0%. BASOPHILIC NORMOBLAST. Size: 10-15 um

reina
Download Presentation

LABORATORY DIAGNOSIS

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. LABORATORY DIAGNOSIS RED BLOOD CELLS

  2. PRONORMOBLAST • Size: 12-20 um • Nucleus: round; nucleoli (1-2); fine chromatin • Cytoplasm: dark blue • N/C ratio: 8:1 • Reference interval: BM: 1% PB: 0%

  3. BASOPHILIC NORMOBLAST • Size: 10-15 um • Nucleus: round; nucleoli 0-1; slightly condensed chromatin • Cytoplasm: dark blue • N/C ratio: 6:1 • Reference interval: • BM: 1-4% • PB: 0%

  4. POLYCHROMATIC NORMOBLAST • Size: 10-12 um • Nucleus: round; nucleoli 0; quite condensed chromatin • Cytoplasm: gray blue • N/C ratio: 4:1 • Reference interval: • BM: 10-20% • PB: 0%

  5. ORTHOCHROMIC NORMOBLAST • Size : 8-10 um • Nucleus : round ; nucleoli = 0 ; fully condensed chromatin • Cytoplasm : blue to salmon • N/C ratio : 0.5:1 • Reference interval : BM : 5-10% PB : 0%

  6. POLYCHROMATIC ERYTHROCYTE • Size : 8-8.5 um • Nucleus : absent • Cytoplasm : blue to salmon • N/C ratio : NA • Reference interval : BM : 1% PB : 0.5% - 2%

  7. ERYTHROCYTE • Size : 7-8 um • Nucleus : absent • Cytoplasm : salmon • N/C ratio : NA • Reference interval : BM : NA PB : Predominant cell type

  8. ERYTHROCYTE: VARIATIONS IN SIZE • ASSOCIATED WITH: iron def. anemia, sideroblastic anemia, thalassemia minor, chronic disease (occasionally), lead poisoning, some hemoglobinopathies MICROCYTE

  9. ERYTHROCYTE: VARIATIONS IN SIZE • Normal erythrocytes are approximately the same size as the nucleus of a small lymphocyte NORMOCYTE

  10. ERYTHROCYTE: VARIATIONS IN SIZE • ASSOCIATED WITH: liver disease, vitamin B12 deficiency, folate deficiency, neonates MACROCYTES

  11. DIMORPHIC POPULATION OF ERYTHROCYTES • ASSOCIATED WITH: transfusion, myelodysplastic syndromes, vit. B12, folate, or iron deficiencies – early in treatment process

  12. HEMOGLOBIN CONTENT OF ERYTHROCYTES • Normochromic erythrocytes

  13. HEMOGLOBIN CONTENT OF ERYTHROCYTES • ASSOCIATED WITH: iron deficiency anemia, thalassemias, sideroblastic anemia, lead poisoning, some cases of chronic disease Hypochromia

  14. HEMOGLOBIN CONTENT OF ERYTHROCYTES • ASSOCIATED WITH: acute and chronic hemorrhage, hemolysis, effective treatment for anemia, neonates Polychromasia

  15. VARIATIONS IN SHAPE AND COLOR Acanthocyte (Spur Cell) ASSOCIATED WITH: abetalipoproteinemia, severe liver disease, splenectomy, malabsorption, hypothyroidism, vit. E deficiency

  16. VARIATIONS IN SHAPE AND COLOR Echinocytes (Burr Cell) ASSOCIATED WITH: uremia, pyruvate kinase def., microangiopathic hemolytic anemia, artifact

  17. VARIATIONS IN SHAPE AND COLOR Spherocytes ASSOCIATED WITH: hereditary spherocytosis, some hemolytic anemias, transfused cells, severe burns

  18. VARIATIONS IN SHAPE AND COLOR Codocyte (Target cell) ASSOCIATED WITH: hemoglobinopathies, thalassemia, iron deficiency anemia, splenectomy, obstructive liver disease

  19. VARIATIONS IN SHAPE AND COLOR Drepanocyte (Sickle cell) ASSOCIATED WITH: Homozygous hemoglobin S disease

  20. VARIATIONS IN SHAPE AND COLOR Stomatocyte ASSOCIATED WITH: Hereditary stomatocytosis, alcoholism, liver disease, Rh null phenotype, artifact

  21. VARIATIONS IN SHAPE AND COLOR Elliptocytes Ovalocytes ASSOCIATED WITH: Hereditary elliptocytosis or ovalocytosis, thalassemia major, iron deficiency anemia, megaloblastic anemias (macro ovalocytes), myelopthisic anemias

  22. VARIATIONS IN SHAPE AND COLOR Schizocyte (Schistocyte) ASSOCIATED WITH: Microangiopathic hemolytic anemia (DIC), severe burns, hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, renal graft rejection

  23. VARIATIONS IN SHAPE AND COLOR Dacryocyte (Tear Drop Cell) ASSOCIATED WITH: Myelofibrosis with myeloid metaplasia, thalassemias, myelophthisic anemias, other causes of extramedullary hematopoiesis

  24. VARIATIONS IN SHAPE AND COLOR Rouleaux formation ASSOCIATED WITH: Increased concentrations of globulins and/or paraproteins

  25. VARIATIONS IN SHAPE AND COLOR Autoagglutination ASSOCIATED WITH: Antigen/ antibody reactions

  26. INCLUSIONS IN ERYTHROCYTES • Color : Dark blue to purple • Shape : round to oval • Size : 1 um • Number per cell : usually 1; maybe multiple • Composition : DNA • Associated with : Splenectomy, hyposplenism, megaloblastic anemia, hemolytic anemia Howell-Jolly bodies

  27. INCLUSIONS IN ERYTHROCYTES • Color : Dark blue to purple • Shape : fine or coarse granules • Number per cell : numerous with fairly even distribution • Composition : RNA • Associated with : Lead intoxication, thalassemia, abnormal heme synthesis Basophilic stippling

  28. INCLUSIONS IN ERYTHROCYTES • Color : light blue • Shape : fine irregular granules in clusters • Number per cell : usually one clusters; may be multiples. Often at periphery of cell • Composition : Iron • Associated with : Splenectomy, hemolytic anemia, sideroblastic anemia, megaloblastic anemia, hemoglobinopathies Pappenheimer bodies (Siderotic granules)

  29. INCLUSIONS IN ERYTHROCYTES • Color : dark blue to purple • Shape : loop, ring, or figure of eight; may look like beads on a string • Number per cell : 1-2 • Composition : thought to be remnants of mitotic spindle • Associated with : Myelodysplastic syndrome, megaloblastic anemia Cabot ring

  30. INCLUSIONS IN ERYTHROCYTES • Stained with New Methylene Blue • Cell : anuclear immature erythrocytes • Composition : precipitated RNA • Number : ≥2/cell • Color : dark blue • Associated with: erythrocyte maturation Reticulocytes

  31. INCLUSIONS IN ERYTHROCYTES • Stained with New Methylene Blue • Cell : mature RBC • Composition : precipitated hgb • Number : single or multiple, generally membrane bound • Color : dark blue to purple • Associated with: Unstable hgb, some hemoglobinopathies, some RBC enzyme deficiencies Heinz bodies

  32. DISEASES AFFECTING ERYTHROCYTES Iron Deficiency Anemia

  33. DISEASES AFFECTING ERYTHROCYTES Thalassemia minor PB : microcytosis, slight hypochromia, codocytes, basophilic stippling

  34. DISEASES AFFECTING ERYTHROCYTES Thalassemia major PB : numerous nucleated RBC’s, microcytes, hypochromia, codocytes, basophilic stippling, many dacyocytes, many schizocytes, polychromasia

  35. DISEASES AFFECTING ERYTHROCYTES Macrocytic anemia (nonmegaloblastic type) PB : round macrocytes (MCV = 112 fl), leukocyte and platelet counts usually normal BM : no megaloblastic changes

  36. DISEASES AFFECTING ERYTHROCYTES Megaloblastic anemia PB : pancytopenia, oval macrocytes, Howell-Jolly bodies, nucleated RBC’s, basophilic stippling, hypersegmentation of neutrophils, giant platelets, codocytes, schizocytes, spherocytes, dacrocytes

  37. DISEASES AFFECTING ERYTHROCYTES Aplastic anemia PB : pancytopenia, normocytic, normochromic (occasional macrocytes) BM : hypocellular; lymphocytes may predominate

  38. DISEASES AFFECTING ERYTHROCYTES Immune Hemolytic Anemia PB : spherocytes, schizocytes, polychromasia, nucleated RBC’s

  39. DISEASES AFFECTING ERYTHROCYTES Hemolytic Disease of the Newborn PB : increased number of nucleated erythrocytes, macrocytic/normochromic, polychromasia, spherocytes

  40. DISEASES AFFECTING ERYTHROCYTES Hereditary Spherocytosis PB : Spherocytes (variable in number), polychromasia; nucleated erythrocytes possible

  41. DISEASES AFFECTING ERYTHROCYTES Hereditary Elliptocytosis PB : >25% elliptocytes, usually >60% elliptocytes; indices are normocytic, normochromic

  42. DISEASES AFFECTING ERYTHROCYTES Hemoglobin CC disease PB : Codocytes, spherocytes, microcytes, polychromasia, intracellular or rod-shaped crystals possible

  43. DISEASES AFFECTING ERYTHROCYTES Hemoglobin SS disease PB : Drepanocytes (in crises), codocytes, nucleated rbc’s, schizocytes, Howell-Jolly bodies, basophilic stippling, polychromasia, increased leukocyte count with neutrophilia, increased platelet count

  44. DISEASES AFFECTING ERYTHROCYTES Hemoglobin SC disease PB : Few sickle cells, codocytes, intraerythrocytic crystals. Crystalline aggregates of hemoglobin SC may protrude from the erythrocyte membrane

More Related