WBC ABNORMALITIES Flashcards
GRANULOCYTE NUCLEAR ABNORMALITIES
1.___________ neutrophils have more than ____ lobes and are usually larger than normal neutrophils
2.___________Nuclei may appear round, ovoid, or peanut shaped (_______[more dangerous) what disease?)
Bilobed/Multilobed? forms the characteristic spinach/spectacle-like (“____-___”, _____ peanut) morphology with the nuclei attached by a thin/thick filament (________ Pelger-Huet)
3.____________Usually a neutrophil that has ingested the ____-____ ______ of another neutrophil or has engulf the ________, _______ nuclear _____ of destroyed cell
Presence of: ANTI-_______ ANTIBODIES, cell nuclei, phagocytes with ingested material
Usually mistaken with a ______ _____ (monocyte with an ingested _______)
4. ____________
Represents the 1st/2nd __ chromosome in males/females
Seen in__-___% of _______
Characteristic “________” appearance of neutrophils
GRANULOCYTES CYTOPLASMIC ABNORMALITIES
1.____________ Lightly/Darkly staining ________ (____-___color) cytoplasmic granules in ________ (less often in monocytes and lymphocytes)
Abnormal large _____ granules
Granules contain degraded _________ due to an _____ defect.
May resemble _____ granules (seen in infections and toxic states)
2._________ (___-____color) spindle shaped inclusions in the cytoplasm
-Large _____ _____-____ inclusions in ______,_______, ______, and ______
-The _______ Dohle body-like _____ inclusions are composed of precipitated ______ _____ ____ (______)
-_______ Dohle bodies consist of _______ rows of _____ ________ _______ (_____)
3.__________
Giant ___, ____, to _____ oval/round? inclusions in the ______
Giant ________ granules in GLM
Cells in the body are affected and exhibit abnormally _____ ______, which contain _____ ________ granules
_____-Chediak-Higashi granules are cytoplasmic inclusions that resemble the fused ______ granules in Chediak- Higashi syndrome
4._________
_____ or _______ shaped cytoplasmic granules; found in ______ and _____ series only
Fused ________ granules (_______ _____ positive)
_____ _____: bundle of auer rods (seen in _____ ___________ ________(___); also associated with ______)
- Hypersegmented- 5
- Hyposegmented neutrophils
Homozygous:Pelger-Huet
Heterozygous: bilobed, spectacle-like (pince-nez, dumbell peanut) - Le Cell- antibody-coated, homogenous, globular nuclear mass; Anti-nuclear antibodies; tart cell
(monocyte w/ an ingested lymphocyte) - Barr body(sex chromatin): 2nd X chromosome in females; 2-3% of neutrophils; DRUMSTICK appearance
- Alder-reily Anomaly-
darkly staining metachromatic (purple-red) cytoplasmic granules in granulocytes
primary granules
degraded mucopolysaccharides precipitated myosin heavy chains(mRNA)
True Dohle-bodies: lamellar rows of rough endoplasmic reticulum(rRNA) - Chediak-Hegashi Syndrome-
giant red, purple, grayish round inclusions in the cytoplasm
giant lysosomal granule
Abnormal large lysosomes containing fused dysfunctional granules
Pseudo-Chediak Hegashi syndrome- lysosomal granules - Auer Rods-
pink/red; myelocytic and monocytic series only
Fused primary granules (Peroxidase Stain positive)
Faggot cells(acute promyelocytic leukemia APL); DIC
REACTIVE CHANGES/SECONDARY MORPHOLOGICAL CHANGES
- ____________ _________
- Appears as ___-____-____ granules in the cytoplasm of _____-, usually in ______ and _____ forms
- Granulation may represent the precipitation of ______ ____(____) caused by ________ _______ within the cells
- Are ______ positive and reflect an increase in ______ _______ within ______, ______ granules that may enhance bactericidal/parasitic? activity
- The extent of toxic granulation is usually graded on a scale of ___+to___+, with ___+ being the most severe. Grading of the granulation is dependent on the _______ and amount of _______ within the cellular cytoplasm.
- Primary/Secondary granules are larger than primary/secondary granules
- TOXIC GRANULATION CAN MIMIC _________ FOUND IN ___________; one helpful defining characteristic of toxic granulation is that in most cases, not all ______ are equally/unequally? affected - ___________
- Are light/___ _____ _______ or _______ cytoplasmic inclusions between __-__um consisting of remnants of ribosomal ________ ___(___) arranged in parallel row; close to cellular membranes
- Are typically found in _____ and ______ neutrophils and can appear together with toxic granulations; can be seen in eosinophils, basophils, monocytes, and lymphocytes
- Localized failure of cytoplasmic ______
- ____ reaction positive
- A delay in preparing the blood film after collection may affect Dohle body appearance in that they are more ____ than blue or in some cases may not be visible
- Confused with_____-_____granules
3.________
-Less encountered than toxic granules and Dohle bodies
-Reflect _______, either of self (__________) or of _______ material
A. ________ vacuoles
Tend to be small (approximately ___ um) and distributed throughout the _______
-Autophagocytosis can be induced by specimen storage in (_____) for____hours, ______, acute _______, and exposure to high doses of ________.
B. _________ vacuoles
Tend to be large (up to __ um) and often accompanied by ______ granulation induced by either bacteria or ____ are suggestive of ______.
-When phagocytic vacuoles are seen, a careful examination sometimes reveals _______ within the vacuoles
- Toxic granules
- dark, blue-black granules of neutrophils; in band and segmented forms
- Granulation: precipitation of ribosomal proteins (RNA) enhance bactericidal activity
- 1+-4+, 4+. coarseness and amount of granulationw/in the cellular cytoplasm
- primary larger than secondary
- MIMIC GRANULATION of Alder Reilly Anomaly
- GRANULATION: neutrophils are equally affected - Dohle-Amato Bodies/Dohle Bodies
- light/pale blue round or elongated cytoplasmic granules
- ribonucleic acid (rRNA)
- band/segmented neutrophils
- seen in BELM(basophils, eosinophils, lymphocytes, monocytes)
- cytoplasmic maturation
- PAS reaction (+)
- Delay: more gray than blue
- confused with May-Hegglin granules - Cytoplasmic vacuoles
-phagocytosis, autophagocytosis, extracellular material
A. Autophagocytic vacuoles
-small (2um)
-EDTA, >2hrs, autoantibodies, alcoholism,radiation
B. Phagocytic vacuoles
-6um
-toxic granulation
-bacteria or fungie>sepsis
-organism
1.
______ nuclei
-in neutrophils generally indicate imminent cell ______.
-_____ has been lost and the _____ becomes dense and light/dark;however, chromatin or ______ can still be seen between nuclear ____ (depending on whether the cell is a band or segmented form)
______nuclei
-are found in _____ neutrophils/______ neutrophils
-they are ovoid/rounded? nuclear fragments with/without? filaments and chromatin _____.
-Increased numbers of pyknotic or necrotic cells suggest that an extended amount of time has elapsed between blood ______ and blood _____ ________.
2._________
Is a result of osmotic/isotonic swelling of the ______ or by increased _____ to the glass slide in stimulated ______.
-Regardless of the cause, the result is a variation in neutrophil ____ or neutrophil _______.
3.__________
Are small, _____, intracellular/extracellular? BACTERIA transmitted by ______ to humans and other vertebrate hosts
-These organisms grow as a ______ (cluster) in _______ and ______.NM
-Morulae(cluster) can be mistaken for
Dohle bodies in _______.
Neutrophils→ Anaplasma _______ and rarely in Ehrlichia ______.
Monocytes→ Ehrlichia ________.
-_________(HGE) is transmitted by the black-legged tick (Ixodes ______) and the western black-legged tick (I. ______)
4.____________
_________(microorganism) is a ____; this organism lives intracellularly/extracellularly? in cells of the________ ________ system, cells of the ____ _______ or cells from ____ or _______ specimens
-The fungus appears as a tiny/large? oval body with a clear ____ surrounding a small/large? nucleus
1A. Pyknotic nuclei -iminent cell death -water lost, chromatin dense and dark -chromatin or filaments @nuclear lobes 1B. Necrotic nuclei -neutrophils/necrobiotic neutrophils -rounded nuclear fragments w/o filaments and chromatin pattern -blood collection and film preparation
- Cytoplasmic swelling
- osmotic swelling of the cytoplasm
- increased adhesion to the glass slide in stimulated neutrophils
- -variation in neutrophil size/anisocytosis - Ehrlichia and Anaplasma
- small, obligate, intracellular bacteria
- ticks
- morulae (cluster) in neutrophils and monocytes
- morulae mistaken for> Dohle bodies in neutrophils
- Anaplasma phagocytophilum and Ehrilichia ewingii
- Ehrilichia chaffeensis
- Histoplasma
- H. capsulatum-fungus> intracellularly in cells of the mononuclear phagocytes system, cells in bone marrow, sputum, effusion spx
- tiny oval body w/ a clear halo surrounding small nucleus.
LYMPHOCYTE ABNORMALITIES
1._________
-Associated with Degenerated nucleus or ruptured cell in form or ________.
-_________ APPEARANCE
-FRAGILE -_______ that appear
during ______ preparation
- ________→ appear at the end of smears
2._________
-____- like cytoplasmic projections surrounding the nucleus (___-____ appearance)
-Nearly all blood cells contain (how many?) non-______ -______ of ACP (,,,,,)
-Isoenzyme __ (tartrate resistant is produced in abundance in hairy cell leukemia)
-_____ positive [only cell positive]
3.________
Lymphocyte with ______ nucleus/___-_____nucleus
Presence indicates ______ PHASE of ______ ______ (sezary syndrome) [abnormal T lymphocyte]
______ ______ (abnormal/cutaneous T-cell lymphoma)
______ ______ (Variant of mycoses fungoides)
4.____________
Abnormal lymphocyte with an “owl’s eye- appearance”
Pathognomonic sign for _______ ________[one of the deadliest]
- ____________
Lymphocyte with a ____ ____- like nucleus
6.__________
-Reactive changes in lymphocyte morphology occur as lymphocytes are stimulated when interacting with _____ in ______ ________ organs
-AKA variant, atypical, transformed, effector, plasmacytoid, Turk cells, Downey, and immunoblasts -B and T lymphocyte activation results in the transformation of small, resting ______ into proliferating _____ cells
-________ lymphocytes often present as a ________ population of various shapes and sizes
-A _______ lymphocyte is a type of reactive lymphocyte that has some morphologic features of ______ cells
TYPES:
Type I: ____ _____ _____ _____; lymphocyte with a large block of _____
Type II: also known as___ _____; round mass of chromatin (______ ___ appearance)
Type III: _______ (_____ _____ appearance)
- _______
- Abnormal ____ cell with red to pink cytoplasm
- Associated with increased Immunoglobulins (usually ____);
- Inclusion: _____ bodies (individual/group bodies of Immunoglobulin)
8._______
Abnormal plasma cell with small colorless/colored? vacuoles
AKA ____, ____, ____ Cell
Inclusions: ______ bodies (intranuclear
protein inclusions)
Large protein globules giving appearance of ___: “______ appearance”
- Basket/Smudge Cell
- basket/smudge
- Thumbprint appearance
- Fragile lymphocytes> smear prep
- Artifact - Hairy cell
- hair-like cytoplasmic projections
- fried-egg appearance
- 7 non-erythroid isoenzymes (0,1,2,3b,4,5)
- 5
- TRAP - Sezary cell
- convoluted nucleus/ brain-like nucleus
- LEUKEMIC PHASE of mycosis fungoides
- Mycosis fungoides
- Sezary syndrome - Reed-Sternberg appearance
- Hodgkin’s lymphoma - Rieder cell
- clover leaf like nucleus - Reactive lymphocyte
-antigen in peripheral lymphoid organs
-lymphocytes into proliferating large cells
-Reactive, heterogeneous
-plasmacytoid lymphocyte- morphologic features of lymphoid cells.
Type 1: Tur’s irration plasma cytoid- large block of chromatin
Type 2: IM cells (ballerina-like appearance)
Type 3: Vacuolated (swiss-cheese) - Flame cell
- plasma, red-pink
- IgA
- Russel bodies (individual bodies of Ig) - Grape cell
- colorless vacuoles
- AKA Berry, Mott, Morula cell
- Dutcher’s bodies
- grapes, Honeycomb appearance
MONOCYTE/MACROPHAGE
ABNORMALITIES
- _________
- are ______ macrophages, _____ or in ____ -abundant fibrillar blue-gray cytoplasm with a ______ or _______ appearance (sometimes described as onion skin-like)
- Positive with ____, _____ ______, ____ and ____ _______
2.________
Macrophages with cytoplasm packed with ___ filled lysosomes that appear as small vacuoles (____) after staining
3.________
Are macrophages with _______ ________, and ______ contained in cytoplasmic granules,____ um in diameter, that appear blue with_____ ____
- Gaucher cell
-distinctive macrophages, single or in group
-trichrome, PAS, aldehyde fuchsin, acid phosphatase
2.Foam cell
-lipid filled lysosomes
-foam
3.Sea b
lue histocyte
-lipofuscin glycophospholipid and spingomyelin
-1-3um
-writhg stain
