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

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Flashcards in 8/12- Lab: Morphologic Abnormalities of WBC and Platelets Deck (43):
1

What is this? 

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Macrophage

- Can see vacuoles where it has eaten something

2

What is this? 

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Neutrophil

- Coarser cytoplasm

- Pink granules (not as course as eosinophil)

3

What is the relative granule coarseness for granulocytes?

Basophil > Eosinophil > Neutrophil

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4

What is this?

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Toxic Granulation

- Neutrophils typically have very fine granules, but they are more coarse here

- Smaller than typical basophil granules and slightly different color

5

What is this?

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Dohle Bodies

- Bluish inclusions in cytoplasm

- Remnants of RER or leftover free ribosomes

- Usually indicative of reactive process, but may be a benign condition

6

What is this? 

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Cytoplasmic Vacuoles

- Clear areas

- Debris present in vacuoles

7

What do these all have in common? 

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They are "Toxic" Changes

- Dohle bodies

- Toxic granulation

- Cytoplasmic vacuoles

- Band forms (not multilobulated nuclei); left shift

8

What is this? Benign or Malignant?

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Pelger Huet Anomaly

- Neutrophils have only 2 lobes (same size, look like spectacles)

- Benign; does not change function of the cell

9

What is this?

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Stodtmeister cell

- No lobation of neturophil nucleus at all (subcategory of Pelger Huet anomaly?)

10

What is a leukemoid reaction?

Increased numbers of WBCS

- Infection

- Stress

- Trauma

- Childbirth

11

What is seen here? 

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Many neutrophils

- Leukemoid reaction (typ increase in WBCs is mostly neutrophils?)

12

What is seen here? 

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Eosinophilia

- Characteristic 2 lobes and nice, bright, eosinophilic granules

13

What may cause eosinophilia?

- Allergic reactions

- Drug allergies

- Parasitic infections

14

What is seen here? 

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Lymphocytosis

- Coarse chromatin

- Slightly more cytoplasm than would normally be seen (somewhat reactive)

15

What is seen here?

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Atypical lymphocytes

- Much more cytoplasm

- Somewhat glassy cytoplasm

- "Hugging" other cells; indented by RBCs

- These are reactive changes

16

When might you see atypical lymphocytes (reactive)?

EBV

17

What is this? 

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Leukoerythroblastic

- In center: immature myeloid cell

- Immature cells coming out of bone marrow (myeloid and erythroid)

18

What is this? 

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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

What is this? 

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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

What is this?

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More blasts in AML

- Myeloid blasts

- Prominent nucleoli

21

What is seen here? 

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AML

- Auer Rods

- FOR SURE MYELOID BLASTS!!!

22

What is this? 

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Multiple Auer Rods- AML

23

Sudan black is used for what? What is this? 

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Sudan Black is a cytochemical stain

- This is AML (confirms myeloid blasts)

24

What is this?

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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?

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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? 

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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? 

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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? 

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Lymphoblast

- Very dense, hardly any cytoplasm 

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29

What is this? 

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ALL (bone marrow)

30

What is this? Genetic cause? 

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Burkitt Leukemia (BM)

- Translocation 8;14

- Can see nice cytoplasmic vacuoles

- Lymphoid-looking cells - All look similar

31

What is this?

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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? 

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Chronic Lymphocytic Leukemia (CLL)

- Smudge cells (very fragile cells; not much cytoplasm)

- Abnormal clumping in lymphocytes

33

What is this? 

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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? 

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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? 

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CML- Chronic Myelogenous Leukemia

- t9;22 (translocation)- Philadelphia chromosome

- Myeloid cells are taking over

36

What is this? 

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Chronic Myelogenous Leukemia (CML)

37

What is this? 

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CML (Basophilia)

- Hardly ever see basophils in peripheral blood

- Many immature myeloid cells

38

What is this? 

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Essential Thrombocytosis

- Another myeloproliferative neoplasm

- Increased platelets (no benign reason for this)

- Platelets do look normal (normal size and granules)

39

What is this? 

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Megathrombocyte (giant platelet)

- About the same size as a RBC

- Just see cytoplasm and granules (no nucleus)

40

What is this? 

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Tear Drops

- Tells us there is myeloproliferative issue in the bone marrow

41

What is this? 

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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? 

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Myelodysplastic syndrome (MDS)

- Left arrow = Pseudo Pelger Huet cell

- Right arrow = blast

43

What is this? 

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Myelodysplastic syndrome (MDS)

Top: Hypoblated pseudo Pelger Huet cells

Bottom L: Dysplasia in erythroid precursor (D)

Bottom R: Hypogranular and hypolobulated