ICSH Recommendations For Peripheral Blood Cell Morphology Standardization and Grading

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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology

Standardization and Grading
Image S1: acanthocytes
Abetalipoproteinaemia - typical
hyperchromic cells with projections of
variable length, thickness and shape
J. Burthem, M. Brereton
Image S2: bite cells
Three bite cells
Image S3: blister cells
G6PD deficiency (drug induced

haemolysis) - frequent blister cells with
associated damaged cells
Image S4: echinocytes
Renal failure – cells with evenly spaced,

short, blunt projections
2
Image S5: ovalocytes and

elliptocytes
Hereditary elliptocytosis
Image S6: irregularly

contracted cells
Unstable haemoglobin
Image S7: schistocytes
Thrombotic thrombocytopenic purpura – a

wide range of fragmented red cells with
polychromatic cells and other damaged
cells. Platelets are absent from the film
Image S8: sickle cells
Sickle cell disease – typical forms

together with other features,
notably polychromasia, target
cells, and a spherocytic cell.
3
Image S9: spherocytes
Autoimmune haemolytic anaemia – typical

round, dense red cells
Image S10: stomatocytes

Hereditary stomatocytosis
Image S11: target cells
Haemoglobin C disease – target cells in

association with irregularly contracted cells
Image S12: tear

drop cells
Myelofibrosis
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Image S13: basophilic stippling
Myelofibrosis - two stippled cells, one

in teardrop form
Image S14: Howell-Jolly bodies
Auto-splenectomised patient with sickle

cell disease
Image S15: Pappenheimer bodies
Sideroblastic anaemia – red cells contain

small basophilic inclusions of variable size
and shape in a limited cytoplasmic area
G. Rozenberg
(**copyright – see statement at end)
Image S16: nucleated red blood cell
Myelofibrosis – a typical late stage

nucleated red cell in circulation
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Image S17: large granular

lymphocyte
Large granular lymphocyte from a normal

individual
Image S18: Auer rods
AML – two blast cells containing relatively

blunt-ended, single and multiple Auer rods
Image S19: hypergranulation

(neutrophils)
Hypergranular neutrophils post G-

CSF treatment
Image S20: hypogranulation

(neutrophils)
Myelodysplasia – hypogranular neutrophils.
Note also the atypical nuclear forms
G. Rozenberg

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Image S21: Pelger

Huet neutrophils
Pelger Huet anomaly – classic bi-lobed

cells with dense chromatin
condensation but normal granulation
Image S22: leukaemic

myeloblasts
Acute myeloid leukaemia (AML) –

hypogranular primitive blast cells
Image S23: abnormal

promyelocytes in APL (1)
APML – two hypergranular promyelocytes
Image S24: abnormal

promyelocytes in APL (2)
Abnormal promyelocyte containing

multiple Auer rods (faggot cell)
G. Rozenberg

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Image S25: monoblasts
Acute monoblastic leukaemia –

monoblasts and promonocytes
Image S26: abnormal

promonocytes
Chronic myelomonocytic
leukaemia (CMML)
G. Zini
Image S27: reactive lymphocytes
Infectious mononucleosis – typical reactive

lymphocytes with flowing basophilic
cytoplasm
Image S28: hairy cells

Hairy cell leukaemia
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Image S29: follicular

lymphoma cells
Circulating follicular lymphoma cells –

note the small cells with cleaved nuclei
and sparse cytoplasm
Image S30: plasma cells
Plasma cell leukaemia. Note also the

background protein staining and the
associated red cell rouleaux. Note that
one plasma cell has features of immaturity
and may be regarded as a plasmablast.
Image S31: prolymphocytic

leukaemia cells
B-Prolymphocytic leukaemia
Image S32: chronic

lymphocytic leukaemia cells
Typical CLL lymphocytes with a smudge cell
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Image S33: giant platelets
Myelofibrosis – some large and giant

abnormally granulated platelets and a
micromegakaryocyte
Image S34: hypogranular platelets
Myelofibrosis – variable platelet appearance

with normal and abnormally granulated
platelets together with some large
hypogranular forms
Image S35: micromegakaryocytes
Myelofibrosis – note the typical ‘granulated’

platelet cytoplasm. A bare megakaryocyte
nucleus is also present
** These images copyright: Microscopic haematology: a practical guide for the laboratory 3e (c)
2011, Sydney, Elsevier Australia

ICSH Recommendations For Peripheral Blood Cell Morphology Standardization and Grading

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1

Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology

Image S1: acanthocytes

Image S2: bite cells

Three bite cells

Image S3: blister cells

G6PD deficiency (drug induced

Image S4: echinocytes

Renal failure – cells with evenly spaced,

Image S5: ovalocytes and

Image S6: irregularly

Image S7: schistocytes

Thrombotic thrombocytopenic purpura – a

Image S8: sickle cells

Sickle cell disease – typical forms

Image S9: spherocytes

Autoimmune haemolytic anaemia – typical

Image S10: stomatocytes

Image S11: target cells

Haemoglobin C disease – target cells in

Image S12: tear

Image S13: basophilic stippling

Myelofibrosis - two stippled cells, one

Image S14: Howell-Jolly bodies

Auto-splenectomised patient with sickle

Image S15: Pappenheimer bodies

Sideroblastic anaemia – red cells contain

(**copyright – see statement at end)

Image S16: nucleated red blood cell

Myelofibrosis – a typical late stage

Image S17: large granular

Large granular lymphocyte from a normal

Image S18: Auer rods

AML – two blast cells containing relatively

Image S19: hypergranulation

Hypergranular neutrophils post G-

Image S20: hypogranulation

(**copyright – see statement at end)

Image S21: Pelger

Pelger Huet anomaly – classic bi-lobed

Image S22: leukaemic

Acute myeloid leukaemia (AML) –

Image S23: abnormal

Image S24: abnormal

Abnormal promyelocyte containing

(**copyright – see statement at end)

Image S25: monoblasts

Acute monoblastic leukaemia –

Image S26: abnormal

Image S27: reactive lymphocytes

Infectious mononucleosis – typical reactive

Image S28: hairy cells

Image S29: follicular

Circulating follicular lymphoma cells –

Image S30: plasma cells

Plasma cell leukaemia. Note also the

Image S31: prolymphocytic

Image S32: chronic

Image S33: giant platelets

Myelofibrosis – some large and giant

Image S34: hypogranular platelets

Myelofibrosis – variable platelet appearance

Image S35: micromegakaryocytes