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Full Blood Picture Morphology of Blood Cells

Definition Erythrocytes
FBP = FBC + Differential count (DC) + Histogram + Peripheral Blood Film (PBF) Normal morphology
FBP = Haemogram + PBF (normocytosis normochromia)
Haemogram = FBC + DC + Histogram (non -poikilocytic, poikilocytic)
FBC = CBC = Complete Blood Count Anisocytosis
(microcytosis, macrocytosis)
Poikilocytosis
Concept Anisochromasia
Haemopoiesis occur in Bone Marrow (hypochromia, hyperchromia)
Mature cells circulate in periphery Polychromasia
Pathological process in marrow is reflected in periphery Dimorphism
Extramedullary pathology can cause abnormal peripheral blood picture Inclusion bodies
Based on Morphology, Counts Nucleated red cells
Agglutination
Indications Rouleaux formation
Clinical suspicion of bl ood disorders
Severe anaemia prior to blood transfusion Classification of Poikilocytes
Abnormal FBC/ Histogram Round Elongated Spiculated
Assessment of known blood disorders Spherocytes Ovalocytes/ elliptocytes Schistocytes
Routine medical examination Stomatocytes Teardrop cells Keratocytes
Target cells Sickle cells Echinocytes
Reporting Hb C crystalloids Acanthocytes
RBC : Hb level + Morphology + Others HB S-C hybrids
WBC : Counts + Morphology + Others
Platelet : Counts + Morphology Inclusions in Erythrocytes
Impression : Howell-Jolly Bodies
Suggestion : Basophilic Stippling
Pappenheimer Bodies
Blood Film in Healthy Subjects Malarial Parasite
Healthy Adults Reticulocyte
Slight Anisocytosis/ Poikilocytosis Heinz Bodies
Metamyelocytes/ Myelocytes – rare
Megakaryocytes – very rare
RBC : Platelet = 10-40 : 1
Pregnancy
More variation
↑ MCV (30-35 weeks)
↓ Hb (30-34 weeks)
↑ ESR (Rouleaux)
Numerous polychromatic cells
↑ Retic. Count (6% at 25-30 weeks) Leucocytes
↑ Neutrophil/ Monocyte count
Left Shift
Platelet - Count/ Size usually do not change
Infant & Children
MCV/ MCH ↓ compared to adults
Male- Female have difference in Hb
(RBC, P CV/Hct not present before puberty)
Lymphocyte count ↑
Neonate
Hyposplenic features – Howell-Jolly Bodies, Acanthocytes, Spehrocytes
Hb, RBC, PCV ↑
MCV ↑
Neutrophil, Monocyte, Lymphocyte counts ↑
NRBC & Myelocytes – common
Retic. Count ↑ in 1st 3 days after birth
Premature Neonate
↑ NRBC, Metamyelocytes, Myelocytes, Promyelocytes, Myeloblasts
Hyposplenic features Platelets/ Thrombocytes
Develop eosinophilia often (between 2nd – 3rd weeks after birth) Normal
Large
Hyposplenism Giant
After splenectomy – Thrombocytosis, Neutrophilia Platelet clumps
After Recovery – Neutrophil counts nearly Normal, Platelet high Normal Platelet satellitism
Lymphocytosis, Monocytosis persist
Abnormal RBC features
Target cells
Acanthocytes
Howell-Jolly bodies
Pappenheimer bodies
NRBC
Spherocytes

Circulating non-haemopoietic cells Microorganisms in Blood Film

Endothelial cells Bacteria
Epithelial cells Fungi
Non-haemopoietic malignant cells Parasites