haemato

Erythropoiesis

IDA

Iron deficiency anaemia

hypochromic (pale color-2/3rd of the central concave) microcytic (small in size), anisopikolocyte (different shape and sizes) such as 1. pencil cells,2. microcytes, 3.cigar shaped cells, 4.tear drop cells.

B12 & folate deficiency

show macrocytic cells- the red cells are enlarged in size, the neutrophils are hypersegmented, because nucleus has more than the normal 5 lobes.

Thalassemia-hb defect

anisopoikilosis-hypochromic microcytic cells, fragments, nucleated red cells (reticulocyte),target cells.tear drop cell,polychromatic cell,contracted cell Howeljolly body

Blood smear & HbH Preparation

Golf ball appearance- Hb H inclussion

Target cell

Thalassemia Trait:beta

Thalassemia Major:

 Thalassemia Major (post splenectomy):

Thalassaemia

Sickle cell disease-hb defect

In sickle cell, u can see the RC sickles when exposed to oxidation stress.

Howeljolly body

Elliptocytosis-membrane defect(hemolysis)

G6PD-enzyme defeciency(hemolysis after oxidant stress)

Heinz bodies
Bite cell Blister cell

Anaemia; Reduced bone marrow erythroid

Marrow failure Marrow infiltration
Trephine biopsy (Aplastic Anemia) hypocellular

hypercellular

Marrow infiltration

Normal trephine

Hemolysis

Band P

L B M

Leucocytes

These are the matured white cells. 1. E=eosinophil -orangy granules within the cytoplasm 2. B=basophil -coarse basophilic granules that they obscure the nucleus 3. N=neutrophil-contain granules in the cytoplasm -nucleus has between 2-5 segments 4. L =lymphocyte-large nucleus with scanty cytoplasm 5. M=monocyte-has nuclues and plenty sky-blue cytoplasm 6. Band-form cell is the immatured neutrophil. 7. P=platlet

Morphology
Lymphoblast
Blast size :small Cytoplasm: Scant Chromatin: Dense Nucleoli :Indistinct Auer-rods: Never present

Myeloblast
Large Moderate Fine, Lacy Prominent Present in 50%

Morphology

Acute lymphoblastic leukemia

Acute myeloid leukemia

ALL

contains more than 20% blast cells in the full blood picture.

CLL

mixture of blast and cells at various stages of maturation.

AML

FAB Acute Myeloid Leukemia

M0 Minimally differentiated AML M1 Myeloblastic without maturation Few granules

AML
M2 AML with maturation M3 Acute Promyelocytic Leukemia (APML) 10-15%

Multiple cytoplasmic granules

prominent granules, multiple Auer rods

AML
Acute Myelomonocytic Leukemia M4 -monocytoid differentiation Acute Monoblastic Leukemia M5 >80% are monoblasts

AML
M6 Erythroleukemia (Di Guglielmo)

M7 Acute Megakaryoblastic Leukemia

Cytoplasmic blebs on blasts.

Preponderance of erythroblasts

CML

 Reticulocytosis is a feature of increased red cell production. New methylene blue is used to stain the reticulocytes

 Fragmented cells, and bitten cells are sings of damaged cells occurring in haemolysis

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