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_MS2 HemeOnc > 8/12- Lab: Morphologic Abnormalities of WBC and Platelets > Flashcards

8/12- Lab: Morphologic Abnormalities of WBC and Platelets Flashcards

1
Q

What is this?

A

Macrophage

  • Can see vacuoles where it has eaten something
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2
Q

What is this?

A

Neutrophil

  • Coarser cytoplasm
  • Pink granules (not as course as eosinophil)
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3
Q

What is the relative granule coarseness for granulocytes?

A

Basophil > Eosinophil > Neutrophil

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4
Q

What is this?

A

Toxic Granulation

  • Neutrophils typically have very fine granules, but they are more coarse here
  • Smaller than typical basophil granules and slightly different color
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5
Q

What is this?

A

Dohle Bodies

  • Bluish inclusions in cytoplasm
  • Remnants of RER or leftover free ribosomes
  • Usually indicative of reactive process, but may be a benign condition
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6
Q

What is this?

A

Cytoplasmic Vacuoles

  • Clear areas
  • Debris present in vacuoles
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7
Q

What do these all have in common?

A

They are “Toxic” Changes

  • Dohle bodies
  • Toxic granulation
  • Cytoplasmic vacuoles
  • Band forms (not multilobulated nuclei); left shift
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8
Q

What is this? Benign or Malignant?

A

Pelger Huet Anomaly

  • Neutrophils have only 2 lobes (same size, look like spectacles)
  • Benign; does not change function of the cell
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9
Q

What is this?

A

Stodtmeister cell

  • No lobation of neturophil nucleus at all (subcategory of Pelger Huet anomaly?)
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10
Q

What is a leukemoid reaction?

A

Increased numbers of WBCS

  • Infection
  • Stress
  • Trauma
  • Childbirth
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11
Q

What is seen here?

A

Many neutrophils

  • Leukemoid reaction (typ increase in WBCs is mostly neutrophils?)
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12
Q

What is seen here?

A

Eosinophilia

  • Characteristic 2 lobes and nice, bright, eosinophilic granules
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13
Q

What may cause eosinophilia?

A
  • Allergic reactions
  • Drug allergies
  • Parasitic infections
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14
Q

What is seen here?

A

Lymphocytosis

  • Coarse chromatin
  • Slightly more cytoplasm than would normally be seen (somewhat reactive)
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15
Q

What is seen here?

A

Atypical lymphocytes

  • Much more cytoplasm
  • Somewhat glassy cytoplasm
  • “Hugging” other cells; indented by RBCs
  • These are reactive changes
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16
Q

When might you see atypical lymphocytes (reactive)?

A

EBV

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17
Q

What is this?

A

Leukoerythroblastic

  • In center: immature myeloid cell
  • Immature cells coming out of bone marrow (myeloid and erythroid)
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18
Q

What is this?

A

Acute Myelogenous Leukemia (AML)

  • All the cells look very similar
  • Nucleus is not as dark (chromatin not as clumped)
  • Larger than normal (5-6x RBC)
19
Q

What is this?

A

Closer look at AML

  • Normal lymphocyte in lower middle
  • Other cells are HUGE (blasts)
  • Big nucleus; high N:C ratio
  • Smooth (not clumped) chromatin
20
Q

What is this?

A

More blasts in AML

  • Myeloid blasts
  • Prominent nucleoli
21
Q

What is seen here?

A

AML

  • Auer Rods
  • FOR SURE MYELOID BLASTS!!!
22
Q

What is this?

A

Multiple Auer Rods- AML

23
Q

Sudan black is used for what? What is this?

A

Sudan Black is a cytochemical stain

  • This is AML (confirms myeloid blasts)
24
Q

What is this?

A

Acute promyelocytic leukemia (FAB AML M3)

  • Cells stuck in promyelyte stage (1 step above blasts)
  • Bilobed nuclei
  • Nucleolus
  • Granulate cytoplasm
  • Auer rods
25
What is this?
**Acute myelomonocytic leukemia** with abnormal **eosinophils** (FAB AML M4eo) - Eosinophilia - Hard to differentiate between eosinophil and basophil; showing both types of granules (abnormal) - This is a leukemia because you have blasts in the background - Typically from chromosomal abnormality (**inversion**) in **chrom 16**
26
What is this?
**Acute Monocytic Leukemia** (AML M5) - All monocytes (indented kidney bean nucleus) - delicately folded nucleus _Confirm monocytes with:_ **- Specific esterase:** negative (positive in myeloblasts) **- Nonspecific esterase:** positive
27
What is this?
**ALL- Acute Lymphocytic Leukemia** - Immature lymphocytes - Still blasts! Not clumped chromatin - These are large (mature ones are about same size as RBC) - High N:C ratio
28
How to differentiate between ALL vs. Lymphocyte?
**Lymphoblast** - Very dense, hardly any cytoplasm
29
What is this?
ALL (bone marrow)
30
What is this? Genetic cause?
**Burkitt Leukemia (BM)** **- Translocation 8;14** - Can see nice cytoplasmic vacuoles - Lymphoid-looking cells - All look similar
31
What is this?
**Chronic Lymphocytic Leukemia (CLL)** - Rogue lymphocytes: small, abnormal (NOT BLASTS) - Strange lymphocyte morphology: much coarser clumping - Will have increased WBC count
32
What is seen here?
**Chronic Lymphocytic Leukemia (CLL)** - **Smudge cells** (very fragile cells; not much cytoplasm) - Abnormal clumping in lymphocytes
33
What is this?
**Multiple Myeloma (bone marrow)** - Plasma cells are normally very low in bone marrow (under 5%) (plasma cell dyscrasia) _Can tell they're plasma:_ - Slightly eccentric nucleus - Bluish cytoplasm - Perinuclear clearing
34
What is this?
**Multiply Myeloma (BM)-**- a plasma cell malignancy _Can tell they're plasma:_ - Slightly eccentric nucleus - Bluish cytoplasm - Perinuclear clearing - Clockface nuclei!!!
35
What is this? Genetics?
**CML- Chronic Myelogenous Leukemia** - **t9;22** (translocation)- Philadelphia chromosome - Myeloid cells are taking over
36
What is this?
Chronic Myelogenous Leukemia (CML)
37
What is this?
**CML (Basophilia)** - Hardly ever see basophils in peripheral blood - Many immature myeloid cells
38
What is this?
**Essential Thrombocytosis** - Another myeloproliferative neoplasm - Increased platelets (no benign reason for this) - Platelets do look normal (normal size and granules)
39
What is this?
**Megathrombocyte (giant platelet)** - About the same size as a RBC - Just see cytoplasm and granules (no nucleus)
40
What is this?
**Tear Drops** - Tells us there is myeloproliferative issue in the bone marrow
41
What is this?
**Myelofibrosis (bone marrow biopsy)** **Left:** H and E stain **Right:** Reticulin stain - Looks like they're "streaming"; streaming effect - Things look packed - Reticulin stain is showing much fibrosis (abnormal in bone marrow)
42
What is this?
**Myelodysplastic syndrome (MDS)** - Left arrow = Pseudo Pelger Huet cell - Right arrow = blast
43
What is this?
**Myelodysplastic syndrome (MDS)** **Top:** Hypoblated pseudo Pelger Huet cells **Bottom L:** Dysplasia in erythroid precursor (D) **Bottom R:** Hypogranular and hypolobulated

_MS2 HemeOnc (33 decks)

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