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

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40Normal Cells of the Blood and Hematopoietic OrgansCell Degradation, Special Granulations, and NuclearAppendages in Neutrophilic Granulocytes and NuclearAnomaliesToxic granulation is the term used when the normally faint stippledgranules in segmented neutrophils stain an intense reddish violet, usuallyagainst a background of slightly basophilic cytoplasm; unlike the normalgranules, they stain particularly well in an acidic pH (5.4). This phenomenonis a consequence of activity against bacteria or proteins and is observedin serious infections, toxic or drug effects, or autoimmuneprocesses (e.g., chronic polyarthritis). At the same time, cytoplasmicvacuoles are often found, representing the end stage of phagocytosis (especiallyin cases of sepsis), as are Döhle bodies: small round bodies of basophiliccytoplasm that have been described particularly in scarlet fever,but may be present in all serious infections and toxic conditions. A deficiencyor complete absence of granulation in neutrophils is a sign ofsevere disturbance of the maturation process (e.g., in myelodysplasia oracute leukemia). The Pelger anomaly, named after its first describer, is ahereditary segmentation anomaly of granulocytes that results in round,rod-shaped, or bisegmented nuclei. The same appearance as a nonhereditarycondition (pseudo-Pelger formation, also called Pel–Ebstein fever, or[cyclic] Murchison syndrome) indicates a severe infectious or toxic stressresponse or incipient myelodysplasia; it also may accompany manifestleukemia.
Note the granulations, inclusions, and appendages in segmentedneutrophilic granulocytesabcFig. 13dVariations of segmented neutrophilic granulocytes. a Reactive state withtoxic granulation of the neutrophilic granulocytes, more visibly expressed in thecell on the left (1) than the cell on the right (2) (compare with nonactivated cells,p. 39). b Sepsis with toxic granulation, cytoplasmic vacuoles, and Döhle bodies(arrows) in band cells (1) and a monocyte (2). c Pseudo-Pelger cell looking likesunglasses (toxic or myelodysplastic cause). d Döhle-like basophilic inclusion (arrow)without toxic granulation. Together with giant thrombocytes this suggestsMay–Hegglin anomaly.continued 41
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 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 49: Advancing nuclear contraction and s
Page 71 and 72: Abnormalities of the White Cell Ser
Page 73 and 74: Predominance of Mononuclear Round t
Page 77 and 78: During lymphatic reactive states, v
Page 79 and 80: Extreme transformation of lymphocyt
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:
Predominance of Mononuclear Round t
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
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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
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
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