..

..


..
..

..
.
..


..
.. .. .
..

1
(size) 2
4
8
9
inclusion 10
11
11
(nucleated red blood 11
cell; NRBC)
reticulocyte count 11
12

hypersegmented neutrophil 12
neutrophil with toxic granules 12
atypical lymphocyte 13
(Platelet estimation) 13
15
16
17
17


1. (size)
2. (shape)
3. (staining)
4. (distribution)
5. (inclusion in red blood cell)
6. (infection in red blood cell)
7.

(objective lens) 100X ( 1,000X)

10 oil-power fields (OPF) (examination area)
200
OPF (% abnormal RBC)

grade % abnormal RBC

4+ 76-100
3+ 51-75
2+ 26-50
1+ 11-25
few 5-10

normal
RBC normochromia normocytosis normochromic normocytic RBC

1
 (size)
95% normocytosis
normocytosis 95%
5% anisocytosis

1. normocyte microcyte
2. normocyte macrocyte
3. normocyte, microcyte macrocyte
4. microcyte / macrocyte

normocyte + microcyte normocyte + macrocyte

2
normocyte + microcyte + macrocyte target cell

(size)
1.
anisocytosis (4+, 3+, 2+, 1+, few)
2. anisocytosis microcyte / macrocyte
anisocytosis 1

1. anisocytosis 2+ with microcyte 2+
2. anisocytosis 2+ with microcyte 1+, macrocyte few
3. anisocytosis 2+ with microcyte 1+, macrocyte 1+
4. anisocytosis 1+ with microcyte few, macrocyte few

3
 anisocytosis 2+ with microcyte 2+ anisocytosis 2+ with microcyte 1+,
macrocyte few

95% normocytosis
normocytosis 95%
5%
poikilocytosis

1.
poikilocytosis (4+, 3+, 2+, 1+, few)
2. poikilocytosis
poikilocytosis 1


1. poikilocyte artifact crenated RBC anticoagulant
effect
2. echinocyte (burr cell) crenated RBC
echinocyte (burr cell)
(BUN)

4
 3. fragmented RBC schistocyte / keratocyte
(helmet cell) schistocyte keratocyte acute
hemolysis schistocyte

(platelet estimation on blood smear)

crenated red blood cell schistocyte keratocyte

4.
/ OPF (
10 OPF 200 / 1 OPF)
4.1 tear drop
4.2 bite cell
4.3 blister cell
4.4 ghost cell
4.5 microspherocyte (spherocyte with diameter <6 m)
4.6. macro-ovalocyte

5
tear drop, microspherocyte macro-ovalocyte

bite cell blister cell

Ghost cell

6

1. poikilocytosis 2+ with target cell 2+
2. poikilocytosis 2+ with schistocyte 1+, keratocyte (helmet cell) 1+
3. poikilocytosis 2+ with target cell 2+, bite cell 1 cell / OPF
4. poikilocytosis 2+ with target cell 1+, spherocyte 1+ with microspherocyte 1 cell /
OPF
5. poikilocytosis 2+ with target cell 1+, ovalocyte 1+ with macroovalocyte 1 cell /
OPF
: anisocytosis 4+ poikilocytosis
4+ poikilocyte ( )

spherocyte poikilocyte microcyte

target cell poikilocytosis anisocytosis

- poikilocytosis 4+ with target cell 4+
- anisocytosis 2+ with microcyte 2+ ( target cell 2+)

- poikilocytosis 4+ with target cell 4+

- anisocytosis 2+with macrocyte 2+ ( target cell 2+)

7
 -Poikilocytosis 2+ with target cell 1+,
ovalocyte few, spherocyte 1+ with
microspherocyte 3 cell/ OPF, tear drop 1
cell/ OPF
-Anisocytosis 2+ with microcyte 1+ (
spherocyte target cell
microcyte 1+)
-Hypochromia 1+

( central pallor < 1/3)
95% normochromia
( central pallor > 1/3) 5%
hypochromia



hypochromia Few ( central pallor > 1/3 5-10 %)
hypochromia 1+ ( central pallor > 1/3 11-25 %)
hypochromia 2+ ( central pallor > 1/3 26-50 %)

normochromic normocytic red blood cells hypochromia 3+

8
 polychromasia
/ OPF objective lens
100X 10 OPF 200 / OPF
:

polychromasia 3 / OPF

2
- rouleaux formation
- agglutination
seen found

rouleaux formation agglutination

9
 inclusion
inclusion
- Howell jolly bodies
- basophilic stippling
- Cabot ring
- Pappenheimers body
inclusion OPF
- < 1 / OPF ( field)
- 1-5 / OPF
- > 5 / OPF

Howell-Jolly bodies basophilic stippling

10
 Cabot ring Pappenheimers body

found seen
microfilaria: found seen
malaria
1. genus species (with double multiple infection)
2.
3. % parasitemia (infected RBC)

1. P. falciparum; ring form and gametocyte, % parasitemia = 80%
2. P. falciparum (with double infection); ring form and gametocyte,
% parasitemia = 80%
3. P. falciparum (with multiple infection); ring form and gametocyte,
% parasitemia = 80%

(nucleated red blood cell; NRBC)

NRBC (differential WBC count)
100 NRBC
NRBC / 100 WBC

11
 reticulocyte count
reticulocyte
Wrights supra vital stain 3
1. % reticulocyte
2. corrected reticulocyte count
3. reticulocyte production index (RPI)
corrected reticulocyte count RPI hematocrit

% reticulocyte

hypersegmented neutrophil
neutrophil 5 lobes
band form 100
neutrophil with toxic granules

( granulocytes) toxic granule
with coarse granules

1. neutrophil with toxic granules 1+
neutrophil toxic granules 11-25 granulocytes 100
toxic granules
2. neutrophil with toxic granules 3+ with coarse granules
neutrophil toxic granules 51-75 granulocytes 100
toxic granules

12
 toxic granules toxic granules

atypical lymphocyte
lymphocyte 100

neutrophil 60%
lymphocyte 30%
atypical lymphocyte 10%

(Platelet estimation)
objective lens 100X ( 1,000X)
10 OPF
200 OPF
1 OPF
3
- adequate 5-25 / OPF
- decreased < 5 / OPF
- increased > 25 / OPF
5%
1 4 OPF found seen

- gray platelets platelet with pale stain ( )

13
 - bizarre platelets ( )
- platelet clumping
- large platelet (
> 4 m)
- giant platelet (
> 6 m 75% )

gray platelet or platelet with pale stain bizarre platelet

large platelet large platelet

14
 bizarre platelet giant platelet

1. Bain BJ. Blood cell morphology in health and diseases. In: Lewis SM, Bain BJ, Bates I, eds.
Dacie and Lewis Practical haematology. 10th ed. Philadelphia: Churchill Livingstone Elsevier,
2006: 79-113.
2. Besa EC, Catalano PM, Kant JA, Jefferies LC. Hematology. Maryland: William &
Wilkins,1992.
3. Greer JP, Forester J, Rodgers GM, Paraskevas F, Glader B, Arber DA, Means RT.
Wintrobes clinical hematology.12nd ed. Philadelphia: Lippincott Williams & Wilkins, 2009.
4. Lichtman M, Beutler E, Kaushansky K, Kipps T, Seligsohn U. Williams hematology. 7th ed.
New York: McGraw-Hill, 2006
5. Turgeon ML. Clinical Hematology: Theory and procedure 3rd ed. Philadelphia: Lippincott
William & Wilkins,1999.

-----------------------------------------

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20 .
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22
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24 ..
25 ..

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1. ..
2. ..
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4. ..

1. ..
2. ..
3. ..
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17