Color Atlas of Hematology - Practical Microscopic and Clinical ...

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130Erythrocyte and Thrombocyte AbnormalitiesTable 22 Diagnostic findings and work-up for the most important disorders ofthe red cell seriesClinicalfindingsHb MCH ErythrocytemorphologyReticulocytesLeukocytesSegmentednuclei(%)Lymphocytes(%)Other cellsThrombocytesFatigue,pallor(dysphagia) Ring-shapederythrocytes,anisocytosis n n n - n/Possibly Anisocytosis,fever, weightpoikilocytosisloss n/ n n Possiblyeosinophilsmonocytes left shiftnDiffusesymptoms /n/ All sizes,dimorphic n/ n n - n/Acute n n n n () () - n//hemorrhageSubjaundice n n or pathol., n/ n n Possibly normoblastspossiblyspherocytesn/Spleen Target cells n n n Possibly normoblastsnPallerpossiblyinfectionsand bleedingtendency n n PossiblymonocytesPallorpossiblyalcohol history Macrocytes,megalocytes Possiblyhypersegmentedgranulocytes,possibly normoblasts/nPlethora,possiblyspleen n n n n/ n n - n/Acute bleeding n n () n n n - tendencyDiagnostic steps proceed from left to right. ❘ The next step is usually unnecessary; : . the nextstep is optional; the next step is obligatory. n = normal value, = lower than normal, = elevated,( ) = test not relevant, BSG = erythrocyte sedimentation rate.
Hypochromic Anemias131BSGIron FerritinandothersElectrophoresisTransferrinTentativediagnosisEvidence/further diagnosticsBone marrowRef.pagen n FerritinIron deficiencyanemiaDeterminesource of bleeding;check ironabsorptionErythropoiesis sideroblasts ,iron in macrophagesp. 132? α 2γFerritinn/Acquired/secondaryanemia triggerSearch for(infectious/toxic, paraneoplastic)n n n/ Sideroachresticanemia,myelodysplasia.Erythropoiesis ,sideroblasts iron in macrophagesp. 134. Erythropoiesis , p. 106ring sideroblastspresentn n n/ – n/ Anemia due tohemorrhagingSearch forsource andreason forhemorrhages(Erythropoiesis)p. 140n n n Haptoglobulinn n n Haptoglobulin(n/)HemolyticanemiaEspecially:thalassemia n /(n) n/ (/n) Aplastic anemiaor bonemarrow carcinosiaOsmoticresistance,Coombs test,Hb electrophoresisandfurther testsSearch for triggeror tumor.(Erythropoiesis p. 140, right shift)increased storageof ironp. 138Hypoplasia of allcell series, or carcinomacellsp. 146,148, 150n n n/ VitaminB 12folic acid()MegaloblasticanemiaGastroscopy,determinationof antibodies,possiblySchilling testn/ n Polyeythemia, ALP, progressionDD: hypergammaglobulinemiaErythropoieticmegaloblastsp. 152.Erythropoiesis p. 162n n durationofhemorrhagingPTT n– Thrombocytopenicpurpura(ITP)Search for triggers,possiblyalso for antibodiesElevated megakaryocytecountp. 166
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iiiColor Atlas of HematologyPractic
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vPrefaceOur Current EditionAlthough
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viiContentsPhysiology and Pathophys
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ContentsixAcute Lymphoblastic Leuke
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2Physiology and Pathophysiology of
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Normal Cells of the Blood andHemato
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Normally erythropoiesis takes place
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34Normal Cells of the Blood and Hem
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Advancing nuclear contraction and s
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Note the granulations, inclusions,
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Abnormalities of the White Cell Ser
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Predominance of Mononuclear Round t
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During lymphatic reactive states, v
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Extreme transformation of lymphocyt
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Monotonous proliferation of small l
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Atypical lymphocytes are not part o
Page 89 and 90: Deep nuclear indentation suggests f
Page 91 and 92: Cytoplasmic processes the main feat
Page 93 and 94: Plasmacytoma cannot be diagnosed wi
Page 95 and 96: Atypias and differential diagnoses
Page 97 and 98: Bone marrow diagnosis is indicated
Page 99 and 100: Conspicuously large numbers of mono
Page 101 and 102: Predominance of Mononuclear Round t
Page 107 and 108: Fundamental characteristic of acute
Page 109 and 110: The diagnosis of acute leukemia is
Page 111 and 112: Acute leukemias may also derive fro
Page 113 and 114: New WHO classification: AML with dy
Page 115 and 116: The cells in acute lymphocytic leuk
Page 117 and 118: In unexplained anemia and/or leukoc
Page 119 and 120: The classification of myelodysplasi
Page 121 and 122: Prevalence of Polynuclear (Segmente
Page 123 and 124: Predominance of the granulocytic li
Page 125 and 126: Prevalence of Polynuclear (Segmente
Page 127 and 128: Left shift as far as myeloblasts, p
Page 129 and 130: Bone marrow analysis is not obligat
Page 131 and 132: In the course of chronic myeloid le
Page 133 and 134: Enlarged spleen and presence of imm
Page 135 and 136: Eosinophilia and basophilia are usu
Page 137 and 138: Erythrocyte and ThrombocyteAbnormal
Page 139: Hypochromic Anemias129Insufficient
Page 143 and 144: Small, hemoglobin-poor erythrocytes
Page 145 and 146: Hypochromic erythrocytes of very va
Page 147 and 148: Hypochromic Anemias137Hypochromic S
Page 149 and 150: Hypochromic anemia without iron def
Page 151 and 152: Consistently elevated “young” e
Page 153 and 154: Distribution pattern and shape of e
Page 155 and 156: Conspicuous erythrocyte morphology
Page 157 and 158: Unexplained decrease in cell counts
Page 159 and 160: Hypochromic Anemias149Differential
Page 161 and 162: Thrombocytopenia with leukocytosis
Page 163 and 164: Conspicuous large erythrocytes sugg
Page 165 and 166: In older patients, myelodysplastic
Page 167 and 168: Small inclusions are usually a sign
Page 169 and 170: PlasmodiumfalciparumPlasmodiumvivax
Page 171 and 172: Conspicuous erythrocyte inclusions
Page 173 and 174: Bone marrow analysis contributes to
Page 175 and 176: Thrombocytes: increases, reductions
Page 177 and 178: Thrombocytes: increases, reductions
Page 179 and 180: Variant forms of thrombocyte and me
Page 181 and 182: Thrombocyte proliferation with larg
Page 183 and 184: Cytology of Organ Biopsiesand Exuda
Page 185 and 186: Lymph Node Cytology175Anamnesis- su
Page 187 and 188: Reactive lymph node hyperplasia and
Page 189 and 190: Lymph Node Cytology179Contact witha
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Epithelioid cells dominate the lymp
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In cases of non-Hodgkin lymphoma an
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Accessible cysts (e.g., branchial c
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Tumor cells can be identified in pl
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Viral, bacterial, and malignant men
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191IndexAActinomycosis 179Addison d
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Index193Disseminated intravascularc
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Index195blast crisis 120-121bone ma
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Index197in hemolytic anemia 140orth
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