blood cell morphology session1.ppt
TRANSCRIPT
8/10/2019 Blood Cell Morphology session1.ppt
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Blood Cell MorphologySession 1
Ashraf ShaqalaihBSc(MT), MSc(MT), CLS(H), CLSp(H)(NCA)Clinical Laboratory Specialist in Hematology
andClinical Immunohematologist Technologist
(Lic#238, State of California, USA)
ع
وفقط
يرصحو
دية
الرب
مخرات
مندى
وعض ه
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Normal Blood Cells
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How cells can be recognized or
identified microscopically??????
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1- Cell size:
Blood cells can be discriminated on the basis of their
cell size
Orthochromic
normoblast or also
called as NRBC
(nucleated RBC)
Metamyelocyte
Promegakaryocyte
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2- Overall cell size:
The most immature cells are large insize, as the cell become more and
more mature the overall cell sizedecreases.
Immature More mature More and more mature Mature last stage to PB
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3- Nucleus and its morphological
changes
We look for the following things:
Nucleus to cytoplasm ratio (N/Cratio)
Nuclear shapeNucleolus: size, number
Nuclear chromatin: coarse or fine
Nuclear chromatin arrangementNuclear position
Nuclear lobulation and
number of lobes
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1- N/C Ratio
N/C ratio means the nucleus to cytoplasmratio.
Immature cells have higher N/C ratio thanmature cells
As cell become more mature its nucleus willbe decreased in size and subsequentlycytoplasm increase in amount.
So when you see a cell with high N/C ratioyou become suspicious that it is immaturecell, but this is NOT always true as maturelymphocytes have high N/c ratio.
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The granulocytic maturation series
Myeloblast Promyelocyte Myelocyte Metamyelocyte Band Neutrophil
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Examples: N/C ratio
N/C ratiodecreases as cell
matures
N/C ratio
decreases as cell
matures
N/C ratio
decreases as cell
matures
Myeoblast
Myelocyte
Metamyelocyte Band Neutrophil
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Nucleolus size and their number
Nucleolus are foundin the mostimmature cells, sothere presence alertus that the cell
between our hand isimmature.
Also their numberand size may also
aid in theidentification ofcells.
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Nuclear position:
Position of
nucleus also may
let us be aware of
specific cell type. Plasma cells
have eccentric
position
nucleus
RBC lineage
Neutrophilic Myelocyte
NeutrophilicMetamyelocyte
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2- Cytoplasm: we look for:
Cytoplasm color
Granulation
Type of granules (primary orsecondary)
Granules cover the nucleus or
not??Cytoplasmic inclusion bodies
Rigidity of the cytoplasm (م ى قو ه
)
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Cytoplasm color
Most immature cells will have deepblue cytoplasm as the cells maturethe blue color decreases and
decreases and may be changed toorange color or to gray coloraccording to the cell type.
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Granulation
All red blood cell precursors are NON granulated.
The Myeloblasts are nongranulated (but this maydeviate in specific situations).
The granulocyte precursors are granulated frompromyelocyte to the most mature segmentedforms.
Lymphocytes and its precursors arenongranulated (but there are some cells that aregranulated and these cells are mostly naturalkiller cells (NK)).
Most mature megakaryotcytes are granulated.
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Type of granulationGranules are present in the cytoplasm of cells.
Granulation starts from primary granules oralso are celled azurophilic granules, ornonspecific granules.
These granules are dark blue or even willappear as black according to your staining.
The will appear the specific granules or calledsecondary granules ( for example: Eosinophil
will have orange granules, basophil will havedark blue granules, neutrophils will have pinkgranules)
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Granules cover the nucleus!
Some cells the granules cover thenucleus such as the promyelocyte(primary granules), basophil (specific
granules: dark violet in color andbig), mast cells (same as basophilbut the granule are more numerous).
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Rigidity of the cytoplasm (م ى قو ه
)
This is used to differentiate betweenatypical lymphocyte and monocytesand not all times we we talk aboutthis later on……….
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Cell Maturation
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Erythrocyte recognizable
maturation
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