Histology for PathologyHematopoietic Elements

Theresa Kristopaitis, MDAssociate Professor

Director of Mechanisms of Human Disease

Kelli A. Hutchens, MD, FCAPAssistant Professor

Assistant Director of Mechanisms of Human Disease

Loyola Stritch School of Medicine

Objectives• On a peripheral blood smear identify the following cells: erythrocytes,

platelets, neutrophils, eosinophils, basophils, lymphocytes and monocytes.

• On a peripheral blood smear identify neutrophil band cells (also known as stab cells) and state the clinical significance of their presence.

• On H&E stained sections, identify neutrophils, eosinophils, lymphocytes.• On H&E sections identify plasma cells.• On a stained section identify the 3 major components of bone marrow

(bone trabeculae, hematopoietic cells, adipose tissue).• List the sequence of development of a granulocytes – focusing on the

neutrophil.• On a section of bone marrow, identify a megakaryocyte.• Define “blast cell”.

Granulocytes – Peripheral Blood SmearNeutrophil Eosinophil

Basophil

Agranulocytes – Peripheral Blood Smear

Lymphocyte Monocyte

Peripheral Blood SmearRed blood cells Platelets

H&E Stained Sections

NeutrophilsEosinophils

H&E Stained Section

H&E Section – Plasma Cells

Bone Marrow

Bone

Adipose (fat) cellsHematopoietic

cells

Based on this representative section of normal bone marrow, what is the age the patient?

Granulocytopoiesis

Neutrophilic series A = MyeloblastB = Myelocyte (large cell, rounded nucleus) C = Late myelocyte or early metamyelocyte (nucleus beginning to indent) E = Metamyelocyte (indented nucleus) G = Band cell (much thinner nucleus) F = Segmented (mature) neutrophil

FGEA B C

Megakaryocyte(Mega = Giant)

Fragments of cytoplasm break off to become platelets