ALDER REILLY

NEUTROFILO AGRANULAR

Occurrence in blood: normally not present

Comment: Granulesless segmented neutrophil.

Staining: MGG Magnification: x 1000

GRANULACIONES TOXICAS

Granularity: thick granules, more eosinophilic stained than typical neutrophilic granularity. Single granules with a tendency to aggregate.

Occurrence in blood: normally not present

Comment: Band neutrophil leucocyte with dark, very abundant toxic granulation. Also anisocytosis of erythrocytes. Numerous ovalocytes. Normal platelets.

Staining: MGG Magnification: x 1000

CUERPOS DE DÖHLE

Definition: Dotted inclusions of blue, non-granular cytoplasm in pink cytoplasm of mature neutrophil leucocyte.

Occurrence in blood: normally not present.

Comment: The arrow points Döhle’s body in the granulocyte. Erythrocytes difficult to assess.

Staining: MGG Magnification: x 1000

Definition: Dotted inclusions of blue, nongranular cytoplasm in pink cytoplasm of mature neutrophil leucocyte.

Occurrence in blood: normally not present.

Comment: Döhle’s body pointed by the arrow. Also anisocytosis of erythrocytes.

Staining: MGG Magnification: x 1000

VACUOLAS

Occurrence: normal mature neutrophil leucocytes may contain single small vacuoles in cytoplasm

Comment: Distinct vacuoles changes in the neutrophilic leucocytes. Two target cells and one ovalocyte are present.

Staining: MGG Magnification: x 1000

VACUOLAS

Occurrence: normal mature neutrophil leucocytes may contain single small vacuoles in cytoplasm

Comment: Small vacuoles in a neutrophil leucocyte with fine neutrophilic granulation. Also anizocytosis of erythrocytes. A single spherocyte and a polychromatophilic cell are seen.

Staining: MGG Magnification: x 1000

NEUTRÓFILO APOPTÓTICO/MUESTRA VIEJA

EOSINÓFILO

EOSINÓFILOS *Tamaño: 14 a 16 um *GRANULOS: *Los gránulos tienen una membrana y un núcleo cristaloide, formado por un centro denso que consiste en un polímero de Proteína Básica Principal (PBP).Tóxica para esquistosoma, trichinellas, cél tumorales y causa injuria en el asma

*Matriz granular: menos compacta. -Tiene la Proteína Catiónica de los Eosinofilos: alto contenido en arginina y Zn, No tiene actividad bactericida ,pero es una toxina potente para el esquistosoma -Neurotoxina Derivada de Eosinófilos(NDE) Neurotóxica podría explicar las alteraciones neurológicas que tienen algunos pacientes con hipereosinofilia en el LCR

*Matriz granular: -Peroxidasa de Eo ;resistente al KCN -Colagenasa -Fosfolipasa B yD :anula los fact activ plaq -Beta glucuronidasa -Ribonucleasa -Catepsina -Catalasa -Histaminasa -No poseen FAL ni lisozima

*Otros Gránulos pequeños: Podrían ser de naturaleza lisosómica -Aril sulfatasa: inactiva los péptidos quimiotácticos -Fosfatasa Acida -Leucotrienos, PAF *Citoquímica: Glucógeno (+) en el citoplasma Peroxidasa(+) Sudan(+)

Size of the cell: 15 - 25 m Shape of the cell: oval or round Colour of cytoplasm: pale, covered by granules Granularity: abundant eosinophilic (orange-red) Nucleus' shape: lobulated, semicircular Type of chromatin: condensed Nuclear/cytoplasmic ratio: low or very low

Nucleoli: not visible

Occurrence: blood: 2 - 4 % marrow: < 2 %

Comment: Mature eosinophil leucocyte with bi-lobulated nucleus and typical eosinophil granularity.

Staining: MGG Magnification: x 1000

1. polychromatic normoblast 2. pycnotic normoblast 3. band neutrophil 4. neutrophil myelocyte 5. neutrophil metamyelocyte

Size of the cell: 15 - 25 m

Shape of the cell: oval or round Colour of cytoplasm: pale, covered by granules Granularity: abundant eosinophilic (orange-red) Nucleus' shape: lobulated, semicircular Type of chromatin: condensed Nuclear/cytoplasmic ratio: low or very low

Nucleoli: not visible

Occurrence: blood: 2 - 4 % marrow: < 2 %

Comment: Single eosinophil leucocyte with bi-lobulated nucleus. Also anisocytosis of erythrocytes and ovalocytes. Normal platelets.

Staining: MGG Magnification: x 1000

BASÓFILOS

BASOFILOS *Tamaño:10um .Gránulos metacromáticos por la presencia de glucosaminoglicanos, el núcleo es irregularmente lobulado. Poseen receptores para IgE *GRANULOS: Son gránulos 1º -Peroxidasa -Histamina -Mucoplisacaridos àcidos Heparina -PAF: Activador de la agregación plaquetaria y liberador de serotonina

Size of the cell: 12 - 18 m Shape of the cell: round or oval

BASOFILO

Colour of cytoplasm: light-pink, mostly covered by granules and nucleus Granularity: very dark, basophilic, granules of various size. The amount varies Nucleus' shape: oval shaped in not mature forms; lobular shaped in mature forms Type of chromatin: condensed, pale Nuclear/cytoplasmic ratio: low or very low

Nucleoli: not visible

Occurrence: blood: < 1 % marrow: < 1 %

Comment: Single basophil leucocyte. Also three schistocytes.

Staining: MGG Magnification: x 1000

BASOFILO

MONOCITOS

MONOCITOS  15

A 25 m  GRANULACION AUSENTE O MUY ESCASA  CITOPLASMA CON GRANULACIÓN MUY FINA  CROMATINA GLOBOSA

SISTEMA MONONUCLEAR FAGOCITICO *MONOCITOS *MACROFAGOS -Histiocitos( tejido conectivo) -Macrófagos,alveolares,peritoneales,MO -Celulas Dendríticas -Células de Kupffer -Osteoclasto (hueso) Celulas de Langerhans (piel)

MONOBLASTO Size of the cell: 15 - 25 m Shape of the cell: oval, sometimes round Colour of cytoplasm: blue, usually light Granularity: without granules or a few, azurophilic, fine granules Nucleus' shape: oval, round, sometimes irregular Type of chromatin: coarse chromatin or clumped Nuclear/cytoplasmic ratio: high

Nucleoli: visible, medium or large size, brighter than chromatin, 1 to 3.

Occurrence: blood: not present marrow: < 1 %

Comment: In the picture a monoblast is depicted. Also numerous other maturating cells of granulopiesis are present.

Staining: MGG Magnification: x 1000

1. myeloblast 2. promyelocyte 3. neutrophil myelocyte 4. proerythroblast 5. pycnotic normoblast 6. polychromatic normoblast 7. band neutrophil

MONOBLASTOS

PROMONOCITO Size of the cell: 15 - 25 m Shape of the cell: oval, sometimes round Colour of cytoplasm: light, grey-blue Granularity: without granules or a few, azurophilic, fine granules Nucleus' shape: usually irregular Type of chromatin: coarse chromatin or clumped Nuclear/cytoplasmic ratio: moderate Nucleoli: hardly visible, medium or large size; brighter than chromatin, 1 to 3.

Occurrence: blood: not present marrow: < 1 %

Comment: The arrow indicates a promonocyte with distinct nucleolus.

Staining: MGG Magnification: x 1000

1. myeloblast 2. lymphocyte 3. proerythroblast 4. basophilic normoblast 5. polychromatic normoblast 6. pycnotic normoblast 7. neutrophil myelocyte 8. neutrophil metamyelocyte 9. band neutrophil

PROMONOCITO Size of the cell: 15 - 25 m Shape of the cell: oval, sometimes round Colour of cytoplasm: light, greyblue Granularity: without granules or a few, azurophilic, fine granules Nucleus' shape: usually irregular Type of chromatin: coarse chromatin or clumped Nuclear/cytoplasmic ratio: moderate Nucleoli: hardly visible, medium or large size; brighter than chromatin, 1 to 3.

Occurrence: blood: not present marrow: < 1 %

Comment: Promonocyte in bone marrow. Also numerous other maturating cells of granulopiesis and erythroblasts are present.

Staining: MGG Magnification: x 1000

1. promyelocyte 2. neutrophil myelocyte 3. neutrophil metamyelocyte 4. band neutrophil 5. eosinophil 6. lymphocyte 7. pycnotic normoblast 8. polychromatic normoblast

PROMONOCITOS

MONOCITO Size of the cell: 15 - 25 m Shape of the cell: round, oval or irregular Colour of cytoplasm: grey-blue Granularity: absent or a few, azurophilic, very fine granules Nucleus' shape: usually irregular Type of chromatin: coarse chromatin, clumped Nuclear/cytoplasmic ratio: moderate or low

Nucleoli: not visible

Occurrence: blood: 4 - 8 % marrow: < 2 %

Comment: The arrow indicates a monocyte. Also numerous cells of the granulocytic series at different stages of maturation.

Staining: MGG Magnification: x 1000

1. promyelocyte 2. neutrophil myelocyte 3. neutrophil metamyelocyte 4. band neutrophil 5. segmented neutrophil 6. pycnotic normoblast 7. polychromatic normoblast 8. basophilic normoblast 9. lymphocyte 10. eosinophil

Size of the cell: 15 - 25 m Shape of the cell: round, oval or irregular

MONOCITO

Colour of cytoplasm: greyblue Granularity: absent or a few, azurophilic, very fine granules Nucleus' shape: usually irregular Type of chromatin: coarse chromatin, clumped Nuclear/cytoplasmic ratio: moderate or low

Nucleoli: not visible

Occurrence: blood: 4 - 8 % marrow: < 2 %

Comment: Typical monocyte with abundant purple-blue cytoplasm containing small vacuoles.

Staining: MGG Magnification: x 1000

Size of the cell: 15 - 25 m Shape of the cell: round, oval or irregular Colour of cytoplasm: grey-blue

MONOCITO

Granularity: absent or a few, azurophilic, very fine granules Nucleus' shape: usually irregular Type of chromatin: coarse chromatin, clumped Nuclear/cytoplasmic ratio: moderate or low

Nucleoli: not visible

Occurrence: blood: 4 - 8 % marrow: < 2 %

Comment: Monocyte with moderate nucleus-cytoplasmic ratio, intense basophilic staining cytoplasm in some spots and marbled structure of cytoplasm. Numerous platelets with normal granulation.

Staining: MGG Magnification: x 1000

MONOCITOS

LINFOCITOS 10 a 15 µm  Citoplasma celeste claro  No posee gránulos visibles  Núcleo con cromatina condensada generalmente excéntrico 

Size of the cell: 12 - 18 m Shape of the cell: round, sometimes oval Colour of cytoplasm: blue, usually dark Granularity: not present Nucleus' shape: round

Linfoblastos Type of chromatin: homogenous

Nuclear/cytoplasmic ratio: high Nucleoli: visible, small or medium size, brighter than chromatin, 1 to 2.

Occurrence in blood: not present marrow: < 1 %

Comment: The cell indicated by the arrow is a precursor cell of lymphocytes, photographed within a lymph nodule of the bone marrow. Almost all the surrounding cells belong to the lymphopoiesis.

Staining: MGG Magnification: x 1000

LINFOBLASTO

PRO LINFOCITO

Size of the cell: 10 - 15 m

LINFOCITO

Shape of the cell: round, sometimes oval Colour of cytoplasm: blue Granularity: not present Nucleus' shape: round or slightly oval Type of chromatin: homogenous, condensed Nuclear/cytoplasmic ratio: high or very high Nucleoli: invisible, sometimes hardly visible, small, single nucleous

Occurrence: blood: 25 - 40 % marrow: 5 - 20 %

Comment: The indicated lymphocyte is one of three present in the picture.

Staining: MGG Magnification: x 1000

1. lymphocyte 2. promyelocyte 3. monocyte 4. polychromatic normoblast 5. pycnotic normoblast 6. plasmocyte 7. neutrophil metamyelocyte 8. neutrophil myelocyte

Size of the cell: 10 - 15 m Shape of the cell: round, sometimes oval Colour of cytoplasm: blue

LINFOCITO

Granularity: not present Nucleus' shape: round or slightly oval Type of chromatin: homogenous, condensed Nuclear/cytoplasmic ratio: high or very high Nucleoli: invisible, sometimes hardly visible, small, single nucleous

Occurrence: blood: 25 - 40 % marrow: 5 - 20 %

Comment: Typical small lymphocyte in blood. Also a single schistocyte.

Staining: MGG Magnification: x 1000

NO CONFUNDIR!!!!!!!!

Size of the cell: 15 - 25 m

Shape of the cell: irregular

LINFOCITO GRANDE GRANULAR

Colour of cytoplasm: blue Granularity: a few, thick azurophilic granules Nucleus' shape: oval, irregular Type of chromatin: fine, homogenous Nuclear/cytoplasmic ratio: moderate or low

Nucleoli: not visible

Occurrence blood: < 10 %

Comment: Large granular lymphocyte with typical for the series coarse, azurophilic granularity and clear cytoplasm. Some stomatocytes are also present.

Staining: MGG Magnification: x 1000

LINFOCITOS ACTIVADOS

Mononucleosis

MONONUCLEOSIS

Size of the cell: 10 - 20 m

Shape of the cell: oval

LINFOPLASMOCITO

Colour of cytoplasm: deep blue Granularity: none Nucleus' shape: oval or irregular Type of chromatin: clumped Nuclear/cytoplasmic ratio: moderate or low Nucleoli: invisible or hardly visible, single

Occurrence blood: < 2 %

Comment: Lymphoplasmocyte often has irregular shape of the nucleus, dark marbled chromatin and very strong basophilic staining of the cytoplasm. Platelets are normal.

Staining: MGG Magnification: x 1000

Size of the cell: 10 - 20 m

Shape of the cell: oval Colour of cytoplasm: deep blue

LINFOPLASMOCITO

Granularity: none Nucleus' shape: oval or irregular Type of chromatin: clumped Nuclear/cytoplasmic ratio: moderate or low

Nucleoli: invisible or hardly visible, single

Occurrence blood: < 2 %

Comment: Lymphoplasmocyte is an activated B-cell lymphocyte. The morphology of the cell is between lymphocyte and plasma cell (increased volume of cytoplasm, the beginning of appearance of perinuclear halo, strong basophilic staining cytoplasm). Chromatin is not yet typical for plasma cell.

Staining: MGG Magnification: x 1000

PLASMOCITO O CELULA PLASMÁTICA Size of the cell: 15 - 20 m Shape of the cell: oval Colour of cytoplasm: deep-blue with big perinuclear halo, sometimes single vacuole is present Granularity: none Nucleus' shape: round Type of chromatin: condensed

Nuclear/cytoplasmic ratio: low

Nucleoli: not visible

Occurrence: blood: not present marrow: < 3%

Comment: The arrow indicates a single plasma cell. Besides, most of the cells belong to granulopoiesis.

Staining: MGG Magnification: x 1000

1. eosinophil 2. neutrophil myelocyte 3. promyelocyte 4. neutrophil metamyelocyte 5. myeloblast 6. polychromatic normoblast

PLASMOCITO O CELULA PLASMÁTICA Size of the cell: 15 - 20 m Shape of the cell: oval Colour of cytoplasm: deep-blue with big perinuclear halo, sometimes single vacuole is present Granularity: none Nucleus' shape: round Type of chromatin: condensed

Nuclear/cytoplasmic ratio: low

Nucleoli: not visible

Occurrence: blood: not present marrow: < 3%

Comment: The arrow indicates a single plasma cell. Besides, most of the cells belong to granulopoiesis.

Staining: MGG Magnification: x 1000

1. neutrophil myelocyte 2. neutrophil metamyelocyte 3. band neutrophil 4. lymphocyte 5. promyelocyte 6. proerythroblast 7. eosinophil

Size of the cell: 15 - 20 m

Shape of the cell: oval

PLASMOCITOS

Colour of cytoplasm: deep-blue with big perinuclear halo, sometimes single vacuole is present Granularity: none Nucleus' shape: round Type of chromatin: condensed

Nuclear/cytoplasmic ratio: low

Nucleoli: not visible

Occurrence: blood: not present marrow: < 3%

Comment: Plasma cell in blood with typical perinuclear halo, which is a sign of cell maturation. Also a neutrophil metamyelocyte is present. Erythrocytes are not suitable for making an assessment.

Staining: MGG Magnification: x 1000

CUERPOS DE RUSSELCELULAS MOTT

CUERPOS CRISTALOIDES

ALTERACIONES CUANTITATIVAS

LEUCOPENIA< 3000 GB mm3 CONGÉNITA (KOSTMANN)  POR FÁRMACOS  ALTERACIONES DE ERITROPOYESIS  SESPSIS MALIGNAS  RADIOTERAPIA  QUIMIOTERAPIA 

LEUCOCITOSIS

LEUCOCITOSIS: NEUTROFILIA > 7500/mm3 

     

Fisiológicas: ejercicio, tabaquismo, pospandrial, frío , calor, traumas, náuseas, vómitos, stress psicológico. Síndrome mieloproliferativo. Inflamación/necrosis: infarto, colagenosis, neoplasias. Fármacos: corticoides, antiepilépticos. Metabólicas: acidosis, eclampsia. Hemólisis, hemorragia, hipoxia. DBT

Leucocitosis eosinofílica >400/ mm3    

 

Desórdenes alérgicos. Parasitosis. Infecciones agudas: escarlatina, colagenopatías. Afecciones cutáneas: psoriasis, eczemas, dermatitis. Anomalías hereditarias. Desórdenes GI.

Leucocitosis basofílica > 100/ mm3       

Reacciones de hipersensibilidad Urticaria pigmentosa Colitis ulcerosa Anemia hemolítica Radiaciones LMC Sind. mieloproliferativos

Leucocitosis: monocitosis > 800/mm3        

Sind. Mieloproliferativos Mielodisplasias Leucemia aguda Infecciones bacterianas: rickettsias, protozoarios. Colagenosis. Digestivas: colitis ulcerosas Lupus , artritis reumatoidea. Convalescencia de infecciones.

REACCION LEUCEMOIDE  

     

> 50.000 GB ASOCIADA A PROCESOS INFECCIOSOS (TBC, CLOSTRIDIUM), DROGAS (CORTICOIDES, MINOCICLINA), PROCESOS TUMORALES (CSF-GM, IL 3Y6) EN MO HIPERPLASIA MIELOIDE NORMAL DESVIACIÓN A LA IZQUIERDA DE NATURALEZA POLICLONAL PUEDE AFECTAR GRANULOCITOS, LINFO Y MONOCITOS SCORE DE FAL-L AUMENTADO DIAG DIFERENCIAL DE LMC Y LNC

MON-EOS %/ GB mm3 T°

40

41

25

Nø 40

80

30

39 70

25

LYN 40

38

20

60

20

30

37

15 36

50

10

20

35

5

10 1

2

3

4

5

6

7

8

9

10

11

12

13

FIN