Anisocytosis
- Noticeable variation in size of erythrocyte population
Poikilocytosis
-Presence of red cells of various shapes
Polychromasia
-Erythrocytes display varying degrees of pink-blue when stained
Hypochromia
- Erythrocytes have very large area of central pallor due to decreased hemoglobin content
Hyperchromia
- Erythrocytes have no central pallor and dark red-pink color due to increased hemoglobin content
Four purposes of blood smear examination
Morphology may be of diagnostic importance to the clinician
- difference in size
- difference in shape
- differences in intracellular content
- miscellaneous differences
Normal erythrocyte size
6.2 to 8.2 um in diameter
Biconcave erythrocytes having a diameter of 6.0um or less are called?
Microcytes
Biconcave erythrocytes having a diameter of 8.5um or more are called?
Macrocytes
Spherocytes
- have lost biconcave shape
- spherical
- no central pallor
- hyperchromic
- smaller surface area
Codocytes
- target cells
- central stained area surrounded by pale area surrounded by stained area
Schistocytes
-fragmented erythrocytes
Drepanocytes
-sickle cells
Basophilic Stippling
- erythrocytes display several small blue-black granules scattered throughout cytoplasm
- granules are aggregate ribosomes and polyribosomes
Heinz Bodies
- Intracellular inclusions of denatured hemoglobin
- single or multiple, refractile, irregular, or round bodies
Howell-Jolly Bodies
- remaining fragments of cell nucleus
- round, darkly stained structures
- normally removed by spleen
Pappenheimer Bodies
- aggregates of protein and iron that form from damaged mitochondria
- appear as blue-black dots
Siderocytes
-erythrocytes containing Pappenheimer bodies
Burr cells
- 10 to 30 short blunt, or pointed evenly spaced projections of the cell membrane
- slightly smaller than normal red cells but maintain their central pallor
Crenated cells
- very irregular membrane projections
- projections appear rounded and short on the surface
- appear to have a bubble or drop of water in the center
Rouleaux Formation
-erythrocytes are arranged in rolls or stacks of 4 or more cells
Agglutination
-cells form irregular clumps
Conditions
-schistocytes
-hemolytic anemia, uremia, malignant hypertension, extensive burns, enzyme deficiencies, peptic ulcer, and aplastic anemia
Conditions
-burr cells
-renal disease and burns
Conditions
-spherocytes
-spherocytosis, hemolytic anemia, burn patients
Conditions
-macrocytes
-vitamin B12 deficiency, folate deficiency, alcoholism, liver disease, hypothyroidism, aplastic anemia
Conditions
-hypochromia
-iron deficiency anemia, thalassemia, and lead poisoning
Conditions
-Rouleaux formation
-malignant lymphoma, multiple myeloma
Conditions
-eliptocytosis
-hereditary, megaloblastic anemia, thalassemia, sickle cell trait, HbC trait and severe iron deficiency
Conditions
-drepanocytes
-Hemoglobin S disease
Increased percentage of eosinophils is usually associate with?
-asthma, hay fever, and parasitic infections
In appendicitis, one would expect to find an increased number of?
-segmented and band neutrophils
Basophilia is associated with?
-myelogenous leukemia, and rarely allergic reactions
Chronic tuberculosis and typhus fever are examples of disease in which what leukocyte is increased?
-monocyte
Left Shift
-increased numbers of immature neutrophils
Right Shift
-increased number of hypersegmented neutrophils
Toxic granulation may be seen in which white cell?
-neutrophil
Hypersegmented neutrophils have how many lobes and are associated with what disease?
- more than 5 lobes
- megaloblastic anemia
Increased numbers of which white cell are associated with viral disease such as infectious mononucleosis?
-lymphocytes
Variant Lymphocytes
- may be larger than monocytes
- irregular nucleus
- abundant blue cytoplasm
- granules and vacuoles
- cytoplasm is indented by other cells
Content of toxic granulation
-primary granules
Content of dohle bodies
-RNA
Conditions
-toxic granulation
-severe bacterial infection
Conditions
-dohle bodies
- septicemia, burns, measles, pneumonia
- granulocytic anemia and hemolytic anemia
Conditions
-Auer rods
-acute myeloblastic leukemia
Conditions
-pseudo pelger-huet
-chronic myelogenous leukemia
What are found in May-Hegglin anomaly?
-Giant platelets and dohle bodies
Giant lysosomes are seen in leukocytes in?
-Chediak-Higashi syndrome
Large numbers of smudge cells are associated with?
-chronic lymphocytic leukemia
What is associated with chronic myelogenous leukemia?
- left shift
- increased neutrophils
- increased eosinophils
- increased basophils
What does the X designation on a microscope stand for?
- indicates magnification of lens
The eyepiece on most microscopes have what magnification?
-10X
What does N.A. stand for and what does it tell you about the objective?
- numerical aperture
- tells the resolving power of the objective
- the higher the aperture, the more detail can be seen
What position should the condenser be in (up or down) when you use the oil immersion (100X) lens?
-The condenser should be turned up for higher magnification objectives and set at a lower position for lower power objectives
Why do you need to remove oil from the oil immersion lens after each day’s use?
-The oil will harden and collect dust, which causes interference when viewing a specimen
Which objective should be in place when the microscope is stored?
-4X
Which are the two most commonly used Romanowsky stains?
-Wright and wright-giemsa
For optimum staining the pH of the wright stain must be?
-6.4 to 6.8
Describe the properties of the Wright or Wright-Giemsa stain that aid identification of the differential characteristics of cellular materials
- Methylene blue ions are positively charged and stain the acid components of the cell varying shades of blue to purple
- Eosin ions are negatively charged and stain the alkaline structures of the cell varying shades of orange to pink
- Structures that take up both stains will appear pink to lilac in color
What substance is used as a fixative in staining?
-methanol
If the buffer used for the Wright’s stain is too acidic the red cells will appear?
-red to pink
Normal platelet size
-1 to 4 microns
The cytoplasm of a platelet contains?
-reddish purple granules
Platelet estimate
(total platelets counted/5) X 15x10^3/uL
The process of white cell formation is called?
-leukopoiesis
Reference Ranges
-neutrophils
40-80%
Reference Ranges
-monocytes
2-10%
Reference Ranges
-basophils
0-2%
Reference Ranges
-lymphocytes
25-35%
Reference Ranges
-eosinophils
0-5%
Reference Ranges
-band neutrophils
0-5%
How many lobes does a mature nucleus have?
-3 to 5 segments
The large red-orange granules of the eosinophil contain what substance that attracts which part of the stain?
- contain alkaline substance
- attract eosin
The large blue-black granules of the basophil contain what substance and attracts which part of the stain?
- contains acid substance
- attracts methylene blue
The lymphocyte has what kind of chromatin?
-coarsely clumped
A few small pink granules (azurophilic granules) may be seen in the cytoplasm of which cell?
-Lymphocytes
Vacuoles may normally be seen in which cell?
-Monocyte
Absolute counts
% of cell type in differential X white cell count