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

More documents

Recommendations

Info

162Erythrocyte and Thrombocyte AbnormalitiesPolycythemia Vera (ErythremicPolycythemia) and ErythrocytosisIncreases in erythrocytes, hemoglobin, and hematocrit above the normalrange due to causes unrelated to hematopoiesis (i.e., the majority of cases)are referred to as secondary erythrocytosis or secondary polycythemia.However, it should be remembered that the “normal” range of values isquite wide, especially for men, in whom the normal range can be as muchas 55% of the hematocrit!Table 28Causes of secondary erythrocytosisReduced O 2 transport capacityReduced O 2 release from hemoglobinRenal hypoxiaAutonomous erythropoietin biosynthesis– Carboxyhemoglobin formation in chronicsmokers– High altitude hypoxia, COPD– Heart defect (right–left shunt)– Hypoventilation (e.g., obesity hypoventilation)– Congenital 2,3-diphosphoglycerate deficiency– Hydronephrosis, renal cyst– Renal artery stenosis– Renal carcinoma– AdenomaCOPD = Chronic obstructive pulmonary diseaseAn autonomous increase in erythropoiesis, i.e., polycythemia vera, representsa very different situation. Polycythemia vera—which one mightcall a “primary erythrocytosis“—is a malignant stem cell abnormality ofunknown origin and is a myeloproliferative syndrome (p. 112). Leukocytecounts (with increased basophils) and thrombocyte counts often risesimultaneously, and a transition to osteomyelosclerosis often occurs inthe later stages.Revised Criteria for the Diagnosis of Polycythemia Vera (according toPearson and Messinezy, 1996)— A1 elevated erythrocyte numbers— A2 absence of any trigger of secondary polycythemia— A3 palpable splenomegaly— A4 clonality test, e.g., PRV-1 marker (polycythemia rubra vera 1)— B1 thrombocytosis ( 400 10 9 /l)— B2 leukocytosis ( 10 10 9 /l)— B3 splenomegaly (sonogram)— B4 endogenous erythrocytic coloniesDiagnosis in the presence of: A1 + A2 + A3/A4 or A1 + A2 + 2 BBone marrow cytology shows increased erythropoiesis in both polycythemiavera and secondary polycythemia. Polycythemia vera is themore likely diagnosis when megakaryocytes, granulopoiesis, basophils,and eosinophils are also increased.
Bone marrow analysis contributes to the differential diagnosisbetween secondary erythrocytosis and polycythemia veraabcdeFig. 58 Polycythemia vera and secondary erythrocytosis. a In reactive secondaryerythrocytosis there is usually only an increase in erythropoiesis. b In polycythemiavera megakaryopoiesis (and often granulopoiesis) are also increased. c Bonemarrow smear at low magnification in polycythemia vera, with a hyperlobulatedmegakaryocyte (arrow). d Bone marrow smear at low magnification in polycythemiavera, showing increased cell density and proliferation of megakaryocytes. e Inpolycythemia vera, iron staining shows no iron storage particles.163
Page 3 and 4:
iiiColor Atlas of HematologyPractic
Page 5 and 6:
vPrefaceOur Current EditionAlthough
Page 7 and 8:
viiContentsPhysiology and Pathophys
Page 9 and 10:
ContentsixAcute Lymphoblastic Leuke
Page 12 and 13:
2Physiology and Pathophysiology of
Page 14 and 15:
Page 16 and 17:
Page 18 and 19:
Page 20 and 21:
Page 22 and 23:
Page 24 and 25:
Page 26 and 27:
Page 28 and 29:
Page 30 and 31:
Page 32 and 33:
Page 34 and 35:
Page 36 and 37:
Page 39 and 40:
Normal Cells of the Blood andHemato
Page 41:
Normally erythropoiesis takes place
Page 44 and 45:
34Normal Cells of the Blood and Hem
Page 46 and 47:
Page 49 and 50:
Advancing nuclear contraction and s
Page 51:
Note the granulations, inclusions,
Page 54 and 55:
Page 56 and 57:
Page 58 and 59:
Page 60 and 61:
Page 62 and 63:
Page 64 and 65:
Page 66 and 67:
Page 68 and 69:
Page 71 and 72:
Abnormalities of the White Cell Ser
Page 73 and 74:
Predominance of Mononuclear Round t
Page 75 and 76:
Page 77 and 78:
During lymphatic reactive states, v
Page 79 and 80:
Extreme transformation of lymphocyt
Page 81 and 82:
Page 83 and 84:
Page 85 and 86:
Monotonous proliferation of small l
Page 87 and 88:
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:
Page 103 and 104:
Page 105 and 106:
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 and 140: Hypochromic Anemias129Insufficient
Page 141 and 142: Hypochromic Anemias131BSGIron Ferri
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: Conspicuous erythrocyte inclusions
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
Page 191 and 192: Epithelioid cells dominate the lymp
Page 193 and 194: In cases of non-Hodgkin lymphoma an
Page 195 and 196: Accessible cysts (e.g., branchial c
Page 197 and 198: Tumor cells can be identified in pl
Page 199 and 200: Viral, bacterial, and malignant men
Page 201 and 202: 191IndexAActinomycosis 179Addison d
Page 203 and 204: Index193Disseminated intravascularc
Page 205 and 206: Index195blast crisis 120-121bone ma
Page 207 and 208: Index197in hemolytic anemia 140orth
show all

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

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?