haemato
Erythropoiesis
IDAIDA
Iron deficiency anaemia
•hypochromic (pale color-2/3rd of the central concave) •microcytic (small in size), •anisopikolocyte (different shape and sizes) such as1. 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:
ß Thalassemia Major (post splenectomy):
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 (AplasticAnemia)
Marrow infiltration Normal trephine
hypocellular
hypercellular
HemolysisHemolysis
These are the matured white cells. 1.E=eosinophil -orangy granules within the cytoplasm2.B=basophil -coarse basophilic granules that they obscure the nucleus3.N=neutrophil-contain granules in the cytoplasm
-nucleus has between 2-5 segments4.L =lymphocyte-large nucleus with scanty cytoplasm5.M=monocyte-has nuclues and plenty sky-blue cytoplasm6.Band-form cell is the immatured neutrophil.7.P=platlet
Band
P
L
M
N
B
E
Leucocytes
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
AMLM2 AML with maturation
Multiple cytoplasmic granules
M3 Acute Promyelocytic Leukemia (APML) 10-15%
prominent granules, multiple Auer rods
AML
Acute Myelomonocytic Leukemia M4-monocytoid differentiation
Acute Monoblastic Leukemia M5>80% are monoblasts
AML
M6 Erythroleukemia (Di Guglielmo)
Preponderance of erythroblasts
M7 Acute Megakaryoblastic Leukemia
Cytoplasmic blebs on blasts.
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
Maa’ttaufeeq wannajah fi haza al ikhtibar
“…..berdoalah nescaya akan Kuperkenankan”…
Ad dua’ silahulmu’min…
Tawakkal…innallaha ma’na…
“ALLAHUGHOYATUNA”