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):

Thalassaemia Thalassaemia

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”