APUSAN DARAH TEPI

AI SITA
NURAIN
 Pemeriksaan apusan darah
Bertujuan untuk
• Untuk mendiagnosis, pemantauan perjalanan (follow up) penyakit dan respon terapi
• Menilai unsur sel darah (eritrosit, leukosit, trombosit) mencari parasite (malaria, mikrofilia)

Indikasi px apusan darah :

Gejala anemia, neutropenia, trombositopenia
Sitosis dan sitopenia
Splenomegali, limfadenopati/ yang menimbulakn gejala sistemik
Metastasis ke sumsum tulang
Cara kerja
Alat dan bahan

Objek speader Pipet

glass

Bak Bak Timer

pengecet pengering

Sel darah
kapiler
vena
Reagen

Cat Romanowsky
Wright, giemsa may granwald, leisman,
giemsa

Methanol
Untuk fiksasi sediaan

Buffered distilled water ph 7,2

Untuk melarutkan cat.
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Pembuatan preparat

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Interpretasi hasil
Sediaan yang baik
• Tipis
• Rata
• Tidak terputus
Your Picture Here Your Picture Here
• Ekor tidak robek
• Bentuk seperti peluru

Terdiri dari 3 zona

I. Ireguler zone
II. Thin zone
III. Thick zone
IV. Thin zone
V. Even zone
VI. Very thin zone
 Pengamatan mikrosop
100 X 1000 X
Orientasi seluruh LP Penegasan DX
Sel- sel asing parasite Bangunan khas
Jumlah leukosit Estimasi trombosit

400 X
Hitung jenis sel
leukosit
Morfologi sel darah.
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BASOFIL
Ukuran sel: 12 - 18 m
Bentuk sel: bulat atau oval
Warna sitoplasma: merah
jambu, ditutupi granul dan
nukleus
Granularitas: basofilik gelap,
ukuran bervariasi. Jumlah
bervariasi
Bentuk inti: bentuk oval pada
basofil muda dan berbentuk
lobular pada basofil dewasa
Tipe kromatin: padat, pucat
Ratio inti/sitoplasma: rendah
atau sangat rendah
Nukleolus: tak tampak
Distribusi: darah: 0
-1%
sumsum tulang: < 1
%
Perbesaran: x 1000
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EOSINOFIL
Ukuran sel: 15 - 25 m
Bentuk sel: oval atau bulat
Warna sitoplasma: pucat,
ditutupi granul
Granularitas:eosinofilik (orange-
red)banyak, ukuran sama
besar
Bentuk inti: lobulated (biasanya
bilobus)
Tipe kromatin: padat
Ratio inti/sitoplasma: rendah
atau sangat rendah
Nukleolus: tak tampak
Distribusi:
darah: 1 - 3 %
sumsum tulang: < 2 %
Perbesaran: x 1000
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NEUTROFIL BATANG
Ukuran sel: 14 - 20 m
Bentuk sel: oval atau bulat
Warna sitoplasma: pink
Granularitas: sedikit azurofilik
neutrofilik,
Bentuk inti: lonjong, Spt sepatu
kuda atau berlobus tp tidak
bersegmen
Tipe kromatin: padat
Ratio inti/sitoplasma:rendah
atau sangat rendah
Nukleolus: tak terlihat
Distribusi :
darah: 2 – 6 %
sumsum tulang: 5 - 20 %
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NEUTROFIL SEGMEN
Ukuran sel: 14 - 20 m
Bentuk sel: oval atau bulat
Warna sitoplasma: pink
Granularitas: sedikit azurofilik
neutrofilik
Bentuk inti: berlobus(normal
kurang dari 5 lobus)
Tipe kromatin: padat
Ratio inti/sitoplasma: rendah
atau sangat rendah
Nukleolus: tak terlihat
Distribusi :
darah: 50 - 70 %
sumsum tulang: 5 - 20 %
Perbesaran: x1000
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MONOSIT
Ukuran: 15 - 25 m
Bentuk: bulat, oval atau tidak
teratur
Warna sitoplasma: abu-abu biru
Granularitas: tidak ada atau
sedikit granul azurofilik halus
Bentuk inti: biasanya tidak
teratur
Tipe kromatin: kromatin
kasar, berkelompok
Rasio inti/sitoplasma:sedang
atau rendah
Nukleolus: tak terlihat
Distribusi:
Darah: 2 - 8 %
sumsum tulang: < 2 %
Perbesaran:x1000
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LIMFOSIT
Ukuran: 10 - 15 m
Bentuk: bulat, kadang-kadang oval
Warna sitoplasma: biru
Granularitas: tidak ada Bentuk inti:
bulat atau agak oval
Tipe kromatin: homogen, padat Rasio
inti/sitoplasma: tinggi atau sangat
tinggi
Nukleolus: tidak terlihat, kadang-
kadang hampir tidak terlihat , satu
nukleolus kecil Distribusi:
darah: 20 - 40 %
sumsum tulang: 5 - 20 %
Perbesaran:x1000
Pelaporan hasil
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