Week 6: Cell Morphology Wright stain RBC morphology Anisocytosis Poikilocytosis WBC morphology WBC differentials Artifacts

Wright Stain Romanowsky stain family Polychromatic Absolute methanol fixative Methylene blue - basophilic components Eosin - acidophilic components

Smear Making Essential in morphology Wedge method Thickness and length

Key Features Size Nuclear shape Chromatin features Granules and other inclusions Color

Leukocytes Granulocytes: have specific granules Non-granulocytes Eosinophil Basophil Neutrophil Non-granulocytes Lymphocyte Monocyte

Granulocytes Eosinophil Large orange granules <2% in circulation Usually bilobed Increased in allergy, parasites

Granulocytes Basophil Large black-purple granules <1% in circulation Increased in allergy, CML

Granulocytes Segmented Neutrophil Band Small purple granules 54-62% in circulation Coarse chromatin Increased in bacterial infection Band No nuclear filament 3-5% in circulation

Non-Granulocytes Lymphocyte Relatively small Round or oval nucleus Smudged chromatin Basophilic cytoplasm Increased in viral infection 25 - 33% (more in children)

Non-Granulocytes Monocyte Relatively large Grey cytoplasm with vacuoles Irregular nucleus Linear chromatin Increased in chronic infection 3 - 7%

Platelets Cytoplasmic fragments of large megakaryocyte 2-3 mm in diameter with granules Promotes clot formation 8-20 per oil immersion field 150,000 - 400,000/mL

Erythrocyte Morphology Normal: biconcave disc of 7.5 mm diameter Has central pallor (1/3 of diameter) on smear No inclusions

Good Area to Evaluate Morphology

Anisocytosis: Variation in Size Microcytes Macrocytes

Poikilocytosis: Abnormal Shape Target Cells Hypochromic

Poikilocytosis Schistocyte Sickle Cell

Poikilocytosis Teardrop Cell Spherocyte

Poikilocytosis Elliptocyte Stomatocyte

RBC Inclusions, etc. Polychromasia Howell-Jolly Bodies

RBC Inclusions Cabot Ring Basophilic Stippling

RBC Inclusions, etc. Malaria Rouleaux

Too Thick Too Alkaline Too Thin Too Acidic

Unacceptable Slides