1. White Cell Precursors (Myeloid) Prepared By : A. Moghaddam Hematology Supervisor at Pars Hospital Lab

3. Granulocytic Maturation Diagram 340 h (14 day)

5. Myeloblast

6. The least mature precursor in granulopoiesis is the myeloblast, which is released into the blood stream only under pathological conditions. A large myeloblast is shown with a fine reticular nuclear structure and a narrow layer of slightly basophilic cytoplasm without granules (Honey Pattern).

7. Myeloblast and neutrophilic granulocytes with segmented nuclei (blood smear from a patient with AML).

8. Auer Rods

9. Promyelocyte

10. Myeloblast (1), which shows the start of azurophilic granulation (arrow), Promyelocyte (2) with copious large azurophilic granules, typically in a perinuclear location.

12. Myelocyte

13. Myelocyte, (Early myelocyte) The chromatin structure is denser than that of promyelocytes. The granules do not lie over the nucleus (as can be seen by turning the fine focus adjustment of the microscope to and fro). The blood smear is from a case of sepsis, hence the intensive granulation.

14. Metamyelocyte

15. 1) This Metamyelocyte is distinguished from a myelocyte by incipient lobe formation. 2) Transitional form between a metamyelocyte and a band cell. 2 1

16. Band (Stab)

18. 1) Band cells can also occur as aggregates. 2) Segmented neutrophilic granulocytes. 1 2

19. Segmented Neutrophil

21. 1) Large Promyelocyte 2) myelocyte 3) metamyelocyte 4) polychromatic erythroblast (4)

22. 1- Typical myelocyte 2- segmented Neutrophil.

23. Hyper segmented neutrophilic granulocyte (six or more segments). There is an accumulation of these cells in Megaloblastic anemia. Drumstick (arrow 1) as an appendage with a thin filament bridge to the nucleus (associated with the X-chromosome), adjoined by a thrombocyte (arrow 2).

27. Reactive state with Toxic granulation of the neutrophilic granulocytes, more visibly expressed in the cell on the left (1) than the cell on the right (2) (compare with non activated cells.

28. 1) Copious granulation in a band cell (1) (toxic granulation) next to band cells (2) with Döhle bodies (arrows). 2) band cells. 2

30. Reactive state with Toxic granulation of the neutrophilic granulocytes, more visibly expressed in the cell on the left (1) than the cell on the right (2) (compare with non activated cells. Sepsis with toxic granulation, cytoplasmic vacuoles, and Döhle bodies (arrows) in band cells (1) and a monocyte (2).

31. Eosinophil

32. Basophil

33. LYMPHOCYTES & MONOCYTES

35. Lymphoblast.

43. Prolymphocytes.

45. lymphocytes.

46. Hairy Cell Leukemia

47. Reactive lymphocyte

49. Reactive large lymphocyte with moderately abundant gray-blue cytoplasm (1000×).

50. Smudge cell. Nuclear remnant from a damaged/broken white cell

51. Broken cell. A broken cell of the myeloid series with ruptured cell membrane an disintegration of cytoplasmic contents (1000×).

52. Ruptured cell. Ruptured/disintegrating leukocyte (1000×).

53. Basket cells (1000×).

54. Lymphocyte. This is a benign reactive lymphocyte with moderately abundant pale gray cytoplasm hugging the surrounding red cells and distinct separation of chromatin/parachromatin (1000×).

55. Large granular lymphocyte with azurophilic cytoplasmic granules (Wright– Giemsa, 1000×)

56. Plasma cell. Eccentric round nucleus with clumped nuclear chromatin and moderate amount of basophilic cytoplasm with prominent nuclear, or clear zone (1000×).

57. Plasma cells with abundant basophilic cytoplasm, eccentric nucleus, and perinuclear clear Golgi zone (Wright– Giemsa, 1000×).

61. Monocyte

67. Thanks