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

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50Normal Cells of the Blood and Hematopoietic OrgansMegakaryocytes and ThrombocytesMegakaryocytes can enter the bloodstream only in highly pathologicalmyeloproliferative disease or acute leukemia. They are shown here inorder to demonstrate thrombocyte differentiation. Megakaryocytes residein the bone marrow and have giant, extremely hyperploid nuclei (16times the normal number of chromosome sets on average), which build upby endomitosis. Humoral factors regulate the increase of megakaryocytesand the release of thrombocytes when more are needed (e.g., bleeding orincreased thrombocyte degradation). Cytoplasm with granules is pinchedoff from megakaryocytes to form thrombocytes. The residual naked megakaryocytenuclei are phagocytosed.Only mature thrombocytes occur in blood. About 1–4 µm in size andanuclear, their light blue stained cytoplasm and its processes give them astar-like appearance, with fine reddish blue granules near the center.Young thrombocytes are larger and more “spread out;” older ones looklike pyknotic dots.Diagnostic Implications. In a blood smear, there are normally 8–15 thrombocytesper view field using a 100 objective; they may appear dispersedor in groups. To someone quickly screening a smear, they will give a goodindication of any increase or strong decrease in the count, which can beuseful for early diagnosis of acute thrombocytopenias (p. 164 f.).Small megakaryocyte nuclei are found in the bloodstream only insevere myeloproliferative disorders (p. 171).
Megakaryocytes are never present in a normal peripheral bloodsmear. Thrombocytes are seen in every field viewabcdFig. 17 Megakaryocytes and thrombocytes. a Megakaryocytes in a bone marrowsmear. The wide cytoplasm displays fine, cloudy granulation as a sign of incipientthrombocyte budding. b Normal density of thrombocytes among the erythrocytes,with little variation in thrombocyte size. c and d Peripheral blood smearswith aggregations of thrombocytes. When such aggregates are seen against abackground of apparent thrombocytopenia, the phenomenon is called “pseudothrombocytopenia”and is usually an effect of the anticoagulant EDTA (see alsop. 167).51
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iiiColor Atlas of HematologyPractic
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vPrefaceOur Current EditionAlthough
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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 and 50: Advancing nuclear contraction and s
Page 51: Note the granulations, inclusions,
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 107 and 108: Fundamental characteristic of acute
Page 109 and 110: The diagnosis of acute leukemia is
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Acute leukemias may also derive fro
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New WHO classification: AML with dy
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The cells in acute lymphocytic leuk
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In unexplained anemia and/or leukoc
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The classification of myelodysplasi
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Prevalence of Polynuclear (Segmente
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Predominance of the granulocytic li
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Prevalence of Polynuclear (Segmente
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Left shift as far as myeloblasts, p
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Bone marrow analysis is not obligat
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In the course of chronic myeloid le
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Enlarged spleen and presence of imm
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Eosinophilia and basophilia are usu
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Erythrocyte and ThrombocyteAbnormal
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Hypochromic Anemias129Insufficient
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Hypochromic Anemias131BSGIron Ferri
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Small, hemoglobin-poor erythrocytes
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Hypochromic erythrocytes of very va
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Hypochromic Anemias137Hypochromic S
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Hypochromic anemia without iron def
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Consistently elevated “young” e
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Distribution pattern and shape of e
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Conspicuous erythrocyte morphology
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Unexplained decrease in cell counts
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Hypochromic Anemias149Differential
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Thrombocytopenia with leukocytosis
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Conspicuous large erythrocytes sugg
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In older patients, myelodysplastic
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Small inclusions are usually a sign
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PlasmodiumfalciparumPlasmodiumvivax
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Conspicuous erythrocyte inclusions
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Bone marrow analysis contributes to
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Thrombocytes: increases, reductions
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Thrombocytes: increases, reductions
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Variant forms of thrombocyte and me
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Thrombocyte proliferation with larg
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Cytology of Organ Biopsiesand Exuda
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Lymph Node Cytology175Anamnesis- su
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Reactive lymph node hyperplasia and
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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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