Which of the following are polymorphonuclears?

Which of the following are phagocytes?

Which of the following are agranulocytes?

Which of the following is immunocytes?

What is the predominant WBC in an adult?

What is the predominant WBC in <=4 years of age?

On determining WBC maturity, MOST valuable and reliable criterion is nuclear chromatin pattern.

Which of the following are mononuclears?

Which of the following is the earliest recognizable granulocyte precursor using the light microscope?

1 to 5% of the nucleated cells in the bone marrow

relatively larger than the myeloblast

nucleus round to oval, often eccentric

hof” is usually seen in normal promyelocytes but NOT in the malignant promyelocytes of acute promyelocytic leukemia

cytoplasm is evenly basophilic and full of primary (azurophilic/nonspecific) granules

one to three nucleoli can be seen but may be obscured by the granules

6 to 17% of the nucleated cells in the bone marrow

Last stage capable of mitosis

Stage of synthesis of secondary granules (specific granules)

3 to 20% of the nucleated cells in the bone marrow

Nucleoli are absent

aka Juvenile cell

Synthesis of tertiary granules (also known as gelatinase granules) may begin at this stage

First stage of nuclear indentation

9 to 32% of the nucleated cells in the bone marrow

Youngest granulocytic precursor to normally appear in the peripheral blood

secretory granules (also known as secretory vesicles) may begin to be formed during this stage

nucleus: elongated, curved, or sausage-shaped with rounded ends (filaments NOT present)

CLSI recommends that ____ should be included within the neutrophil counts and NOT reported as a separate category (due to the difficulty in reliably distinguishing ____ from segmented neutrophils)

may look very similar to the promyelocytes (EXCEPT that patches of grainy pale pink cytoplasm representing secondary granules start to become obvious in the area of the Golgi apparatus called dawn of neutrophilia

smaller than promyelocytes (15 to 18 um), and the nucleus has considerably more heterochromatin , nucleoli are difficult to see by light microscopy

How long does a myeloblast stay in that stage?

How long does a promyelocytes stay in that stage?

How long does a myelocytes stay in that stage?

The synthesis of PRIMARY GRANULES begins in the:

The synthesis of PRIMARY GRANULES begins in the:

The synthesis of PRIMARY GRANULES begins in the:

nucleus occupies most of the cell, with very little cytoplasm

lightly basophilic cytoplasm, fine nuclear chromatin, and two to four visible nucleoli, no visible granules when observed under light microscopy with Romanowsky stains

shows the presence of dispersed primary (azurophilic/nonspecific) granules in the cytoplasm; the number of granules does NOT exceed 20 per cell

have a darker chromatin and a more purple cytoplasm, and they contain more than 20 granules that do NOT obscure the nucleus

rare in normal bone marrows, but they can be seen in certain types of acute myeloid leukemias

•7 to 30% of the nucleated cells in the bone marrow

Some associated conditions: ✓ Bacterial infections (generally) ✓ Appendicitis ✓ Rheumatoid arthritis ✓ Acute destruction represented by pancreatitis, colitis, myocardial infarction, severe hemolysis, surgical or traumatic wounds, thermal injury ✓ Parasites (malaria, liver flukes) Lithium ✓ Chemicals (lead, mercury) ✓ Drugs (digitalis, phenacetin) ✓ Corticosteroids ✓ Myelogenous leukemia ✓ Venoms (spiders, bees, wasps) ✓ Actinomyces fungi ✓ Response to therapy

usually caused by a shift of marginated cells to the circulatory pool (common reasons for this are: exercise, excessive temperature changes, nausea and vomiting, pregnancy and labor, rage, panic, and stress)

Some associated conditions: ✓ Overwhelming infections ✓ Splenomegaly ✓ Hemodialysis ✓ Copper deficiency ✓ Alcoholism ✓ Babies born from hypertensive mothers ✓ Chemical toxicity (benzene) ✓ Marrow replacement ✓ Nutritional deficiencies ✓ Cytotoxic drugs

Agranulocytosis

neutrophil count of <0.5 x 10^9/L

Associated condition: ✓ ACTH administration ✓ Autoimmune disorders ✓ Steroid therapy ✓ Stress ✓ Sepsis ✓ Acute inflammatory states

Associated condition: ✓ Asthma ✓ Hay fever ✓ Psoriasis ✓ Eczema ✓ Scarlet fever ✓ Eosinophilic leukemia ✓ Parasitic infections

may possibly produce the highest eosinophil count

All of the ff. is commonly associated with moderate to severe eosinophilia except

Associated conditions: ✓ Immediate hypersensitivity reactions ✓ Hypothyroidism ✓ Ulcerative colitis ✓ Estrogen therapy

Associated conditions: ✓Acute infections ✓ Stress ✓ Hyperthyroidism ✓ Increased levels of glucocorticoids ✓ Chronic urticaria

N:C 4:1

N:C 3:1

N:C 2:1 TO 1:1

Nuclear chromatin: reticular

Nuclear chromatin: smooth

Nuclear chromatin: clumped

Nuclear chromatin: slightly clumped

Amount of cytoplasm: scanty

Amount of cytoplasm: slightly increased

Color of cytoplasm: Medium blue

Color of cytoplasm: Moderate blue

Color of cytoplasm: Blue-pink

Color of cytoplasm: Pink

Color of cytoplasm of segmented

Amount of cytoplasm: moderate

Amount of cytoplasm: abundant

Amount of cytoplasm in segmented

Nuclear chromatin: very clumped

Segmented nuclear chromatin

N:C 1:1

Segmented N:C

15 to 20 μm

15 to 18 μm

N:C ratio 4:1

N:C ratio 4:1 to 3:1

large mature lymphocyte NC ratio

small mature lymphocyte NC ratio

small mature lymphocyte size

large mature lymphocyte size

predominant form of lymphocyte (normal adult blood)

composed mostly of the nucleus

scanty cytoplasm

Final maturation stage of B lymphocytes

- Nucleus: small, oval and eccentric : “tortoise shell”, “cartwheel” or “clock face” in appearance

Cytoplasm: dark blue/ sea blue / cornflower in color : may contain round, discrete globules (called: russell bodies) that contain immunoglobulins

Some associated conditions: ✓ Infectious mononucleosis ✓ Infectious lymphocytosis ✓ Cytomegalovirus infection ✓ Acute viral hepatitis ✓ Bordetella pertussis infection ✓ Brucellosis ✓ Toxoplasmosis ✓ Acute HIV infection

Some associated conditions: ✓ Aplastic anemia ✓ AIDS ✓ SARS ✓ Ethanol abuse ✓ Zinc deficiency

Some associated conditions: ✓ Tuberculosis ✓ Subacute Bacterial Endocarditis ✓ Syphilis ✓ Protozoal and rickettsial infections (e.g., malaria, typhus) ✓ Brucellosis ✓ Typhoid ✓ Gaucher disease ✓ Hodgkin’s disease ✓ Collagen vascular diseases (e.g., lupus erythematosus) ✓ Gastrointestinal disease ✓ Surgical trauma

Some associated conditions: ✓ Aplastic anemia ✓ Overwhelming infections in immunocompromised patients ✓ Hemodialysis ✓ Epstein-Barr virus infection ✓ Steroid therapy

Monocytes found in tissues

Most abundant cell type in the body

functions: Phagocytosis ◘ Synthesize nitric oxide (cytotoxic against viruses, bacteria, fungi, protozoa, helminths, and tumor cells) ◘ Release interleukin 1 (stimulates T lymphocytes) ◘ Produce transcobalamin II (the primary transport factor for vitamin B12)

Kupffer cells

Dust cells

Mesangial cells

Microglial cells

Langerhans cells

Littoral cells

Intestinal macrophages

Peritoneal macrophages

Type A cells

Reproductive organ macrophages

Osteoclast

Hoffbauer cells

Dendritic cells

the metabolically active form of Vitamin B12.