Presentation on theme: "Normal Red Blood Cells - Peripheral Blood Smear. Peripheral Blood Cells A. Erythrocytes; B. Large Granular Lymphocyte; C. Neutrophil; D. Eosinophil; E."— Presentation transcript:
Peripheral Blood Cells A. Erythrocytes; B. Large Granular Lymphocyte; C. Neutrophil; D. Eosinophil; E. Neutrophil; F. Monocyte; G. Platelets; H. Lymphocyte; I. Band Neutrophil; J. Basophil
The red blood cells here are normal, happy RBC's. They have a zone of central pallor about 1/3 the size of the RBC. The RBC's demonstrate minimal variation in size (anisocytosis) and shape (poikilocytosis).zone of central pallor
The RBC's here are smaller than normal and have an increased zone of central pallor. This is indicative of a hypochromic (less hemoglobin in each RBC) microcytic (smaller size of each RBC) anemia. There is also increased anisocytosis (variation in size) and poikilocytosis (variation in shape).
Here is a hypersegmented neutrophil that is present with megaloblastic anemias. There are 8 lobes instead of the usual 3 or 4. Such anemias can be due to folate or to B12 deficiency. The size of the RBC's is also increased
Bone marrow -- Megaloblastic anemia -- nuclear/cytoplasmic asynchrony,
Bite Cell -- G6PD Deficiency Clinical? X linked, African American Males, only symptomatic during oxidative stress (meds, fava beans)
Sickle Cells -- Clinical stuff: microvascular occulusions lead to tissue infarcts and pain, autosplenectomy (so no splenomegaly), increased Salmonella osteomyelitis, some aplastic crises (Parvovirus)
Sickle cell anemia in sickle cell crisis. The abnormal hemoglobin SS is crystalizes when oxygen tension is low, and the RBC's change shape to long, thin sickles that sludge in capillaries, further decreasing blood flow and oxygen tension. Persons with sickle cell trait (Hemoglobin AS) are much less likely to have this happen.
Normal bone marrow. Note the presence of megakaryocytes, erythroid islands, and granulocytic precursors. This marrow is taken from the posterior iliac crest in a middle aged person, so it is about 50% cellular, with steatocytes mixed with the marrow elements.
Bone Marrow, Acute Leukemia Age distributions? ALL -- kids (4 yrs peak incidence) AML -- Adults
Bone marrow acute leukemia Symptoms? Fatigue (Anemia), Bleeding (thrombocytopenia), Bone pain, infections, masses, CNS symptoms
Lympoblasts -- ALL Diagnostic criteria? 30+% lymphoblasts in BM, Tdt+, MPO-
AML -- myeloblasts with Auer Rod, worse prognosis than ALL, allogenic Bone Marrow Transplant curative
Chronic Lymphocytic Leukemia - little cytoplasm
These mature lymphocytes are increased markedly in number. They are indicative of chronic lymphocytic leukemia, a disease most often seen in older adults. This disease responds poorly to treatment, but it is indolent.