Term
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Definition
promyelocyte (progranulocyte)
A promyelocyte (#1) is a large cell that contains many purplish-red azurophilic granules in its blue cytoplasm. Its nucleus can be round or slightly indented and usually contains nucleoli. Photo© ASH/Univ. of WA promyelocyte |
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Definition
rubricyte (polychromatophilic erythroblast)
The rubricyte (#3) is the stage of development between the prorubricyte (#2) and the metarubricyte (#4). The rubricyte cytoplasm contains a mixture of both red and blue colors which gives it a more gray appearance. The rubricyte in this image is in the early stages of rubricyte development |
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Term
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Definition
tartrate-resistant acid phosphatase (TRAP) stain
Acid phosphatase isoenzyme activity in hairy cells (staining red-orange) is resistant to incubation with tartrate. Acid phosphatase isoenzyme activity in other cells is destroyed during incubation with tartrate. The TRAP stain is used in the diagnosis of hairy cell leukemia (leukemic reticuloendotheliosis). Photo© ASH/Univ. of WA TRAP stain |
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Definition
basophil
Basophils contain large purplish-blue cytoplasmic granules which can obscure the nucleus. They are very few in number in peripheral blood. |
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Term
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Definition
| The promonocyte (#2) is the stage of monocyte development following the monoblast stage (#1). The cytoplasm in the promonocyte is less blue than in the monoblast and represents a larger portion of the cell size. The nucleus is young in appearance with fine chromatin. |
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Term
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Definition
| acute myelocytic leukemia - M0 |
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Term
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Definition
| The non-specific esterase (NSE) stain is used to differentiate cells of monocytic origin from other cells. Alpha naphthyl acetate or butyrate is used as a substrate for the stain. Monoblasts will contain diffusely positive orange granules. |
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Definition
| Acid phosphatase enzyme is found in all cells. The reddish staining pattern for T cells and lymphoblasts is stippled or dotted. |
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Term
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Definition
May-Hegglin anomaly
In May-Hegglin anomaly, neutrophils and monocytes contain large, blue-staining granules similar to Döhle bodies (RNA). A Döhle body can be seen in the cytoplasm of the segmented neutrophil near its inferior rim. Individuals with May-Hegglin anomaly also have thrombocytopenia with giant platelets. Four giant platlets are seen in this case. |
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Term
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Definition
| Small lymphocytes (#2) are a little larger than a normal RBCs (7-9 microns). They have a very high N:C ratio and sometimes it is very difficult to see any cytoplasm. If present, the cytoplasm is usually dark blue or gray. The nucleus is very dense with clumped chromatin. |
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Term
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Definition
| acute myelocytic leukemia |
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Term
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Definition
neutrophilia
This film shows an increase in the percentage of neutrophils in the blood with a "shift to the left" in the percentage of neutrophilic band forms. |
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Term
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Definition
sea-blue histiocyte
The large cell with the eccentric nucleus and pale blue cytoplasm is found in the bone marrow, spleen and liver of individuals with sea-blue histiocytosis. |
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Term
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Definition
| acute myelocytic leukemia |
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Term
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Definition
chronic myelocytic leukemia (CML, CGL)
CML is characterized by many immature stages of granulocytic development in the peripheral blood. These stages include myelocytes, metamyelocytes, bands and segmented forms. Myeloblasts and promyelocytes can be present but are fewer in numbers. |
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Term
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Definition
prorubricyte (basophilic erythroblast)
A prorubricyte (labeled #2) is the cell stage of development between the rubriblast (#1) and the rubricyte (#3). Notice its dark blue cytoplasm. |
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Term
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Definition
mature erythrocyte
Mature erythrocytes contain no nucleus and stain pinkish-red with Wright's stain. They have a lighter center reflecting their biconcave morphology. |
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Term
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Definition
Chediak-Higashi syndrome
The large, dark granules in the neutrophilic segmented cell are abnormal lysosomal granules. These granules are found in granulocytes, lymphocytes, monocytes, platelets and melanocytes of individuals with Chediak-Higashi syndrome. They are the result of abnormal fusion of primary and secondary lysosomal granules. Abnormal granules result in ineffective enzyme release during phagocytosis. |
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Term
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Definition
neutrophilic metamyelocyte
The neutrophilc metamyelocyte (#2) is the stage of development between the neutrophilic myelocyte (#1) and the neutrophilic band (#3). The nucleus in the metamyelocyte has started to indent but not as much as the band stage. The n. metamyelocyte contains many specific granules with fewer numbers of azurophilic granules. The nuclear chromatin becomes more condensed as the cells mature. Photo© ASH/Univ. of WA neutrophilic metamyelocyte |
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Term
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Definition
| Myeloperoxidase enzyme activity is found only in cells of myelocytic and monocytic origin. It is not found in cells of lymphocytic origin. MPO stain is used to differentiate myeloblasts from lymphoblasts. Myeloblasts that are positive for the enzyme will contain large amounts of darkly-staining granules (above). Lymphoblasts wiil show no staining positivity. Photo© ASH/Univ. of WA MPO stain |
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Term
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Definition
megakaryocyte
The huge cell above is a megakayrocyte in a bone marrow preparation. The cytoplasm of megakaryocytes fragment off to form thrombocytes (platelets). Notice other developing RBCs and WBCs in the field. |
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Term
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Definition
Sudan black B (SBB) stain
Sudan black B stains phospholipids black in membranes of primary and secondary granules in cells of myelocytic and monocytic origin. SBB is the most sensitive stain for myelocytic precursors and is used to differentiate myeloblasts from lymphoblasts. |
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Term
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Definition
monoblast
The monoblast (#1) is the earliest recognizable form of monocyte development. It precedes the promonocyte stage (#2). The monoblast has a high N:C ratio with varying amounts of blue-gray cytoplasm surrounding a nucleus filled with fine, lacy chromatin. Nucleoli are often visible in the nucleus. |
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Term
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Definition
eosinophilia
Eosinophilia is an increase in the number of eosinophils in the blood. This film shows 3 eosinophils in this one field. Normally there are only 0-4 eosinophilis/100 WBCs and not one in every field. Photo© ASH/Univ. of WA eosinophilia |
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Term
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Definition
| acute myelocytic leukemia - M3 |
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Term
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Definition
monocyte
Monocytes are the largest leukocytes in peripheral blood. The cytoplasm of monocytes is pinkish-gray and may contain azurophilc granules and vacuoles. Psuedopod extensions may also be present. The nucleus in a monocyte is not as densely-staining as in a neutrophilic seg. |
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Term
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Definition
| acute myelocytic leukemia - M6 |
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Term
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Definition
periodic acid-Schiff (PAS) stain
PAS stains stains glycogen red in lymphocytes, granulocytes, and megakaryocytes. It is used for diagnosing erythroleukemia. |
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Term
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Definition
diffusely basophilic erythrocyte
The diffusely basophilic erythrocyte (#2) has no nucleus and contains some RNA which gives its cytoplasm a slightly blue appearance with Wright's stain. It is the same cell as a reticulocyte when specially stained with new methylene blue supravital stain. |
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Term
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Definition
| Specific esterase stain (naphthol AS-D chloroacetate esterase, CAE) is positive in neutrophilic granules and mast cells and helps to differentiate neutrophils from lymphocytes and monocytes. Notice the red stain is positive in some of the cells but negative in most of the other cells. The negative cells are lymphocytes. |
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Term
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Definition
neutrophilic myelocyte
The neutrophilic myelocyte (#1) is the stage of development between the promyelocyte and the neutrophilic metamyelocyte (#2). It usually has a 1:1 N:C ratio with a round to slightly indented nucleus. This stage may also have a few nucleoli and is the last cell stage to divide in granulocytic development. A light area in the cytoplasm near the nucleus is the "hof" (Golgi) region. The cytoplasm of neutrophilic myelocytes stains bluish-gray and contains specific granules. |
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Term
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Definition
neutrophilic segmented
Mature neutrophilic segmented cells have dense nuclei that contain 3-5 segments connected by thin filaments of nuclear chromatin. Their cytoplasm is filled with pinkish-gray specific granules. Photo© ASH/Univ. of WA neutrophilic segs |
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Term
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Definition
Gaucher cell
The large bi-nucleated cell with the bluish-purple cytoplasm is a Gaucher cell. It is a histiocyte that may contain one or two nuclei and whose cytoplasm has been described as having a "crumpled paper" appearance. Individuals with Gaucher disease have a deficiency of beta glucocerebrosidase which results in abnormal accumulations of unmetabolized glucocerebrosides in the reticuloendothelial cells in the bone marrow and other organs. |
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Term
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Definition
plasma cell
Plasma cells are found in multiple myeloma and during B-cell humoral immune responses. Notice the eccentric nucleus and dark-blue cytoplasm. The slightly lighter region in the cytoplasm near the nucleus contains the "hof" region (Golgi apparatus). |
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Term
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Definition
| acute myelocytic leukemia - M2 |
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Term
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Definition
lymphoblast
A lymphoblast (#1) has a very high N:C ratio with minimal bluish-staining cytoplasm surrounding a very young appearing nucleus. Several nucleoli may be present in the nucleus. This cell stage is the earliest recognizable form of lymphocyte development. |
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Term
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Definition
| acute myelocytic leukemia - M4 |
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Term
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Definition
Döhle bodies
The neutrophil above contains a large pale-blue Döhle body in the lower right portion of its cytoplasm. Döhle bodies are collections of RNA that are associated with toxicity in the cell. |
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Term
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Definition
hypersegmentation
Hypersegmentation occurs in neutrophlis when there are more than 5 connected segments in the nucleus. The lower cell is a neutrophil that contains one nucleus with 8 segments connected by thin filaments of nuclear material. The upper cell is a normal neutrophil with 4 segments in the nucleus. |
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Term
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Definition
thrombocytes (platelets)
The small, purple cytoplasmic fragments are platelets. They are normally about 1-2 microns in diameter and represent the smallest circulating formed element in the blood. |
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Term
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Definition
rubriblast (proerythroblast)
The rubriblast (labeled #1) is the earliest recognizable stage in red blood cell development. |
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Term
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Definition
infectious mononucleosis
Infectious mononucleosis is characterized by over 50% lymphocytes in the peripheral blood and a wide variety of lymphocyte morphologies. Many of the lymphocytes are reactive lymphocytes with bluish-pink cytoplasm and darkly staining edges. The cells in this case also have some small azurophilic granules in the cytoplasm. |
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Term
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Definition
metarubricyte (orthochromatic erythroblast)
The metarubricyte (#1) has cytoplasm that is pinkish-blue and similar to the cytoplasm in the diffusely basophilic erythrocyte (#2). The nucleus in a metarubricyte has a very dense chromatin pattern and is extruded at this stage of differentiation |
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Term
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Definition
eosinophil
Mature eosinophilic segmented cells contain bi-lobed nuclei and large reddish-granules in the cytoplasm. |
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Term
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Definition
reactive lymphocyte
Reactive lymphocytes, similar to the large nucleated cell in this field, can be 9-30um in diameter. They have abundant cytoplasm, unevenly stained blue cytoplasm with darkly staining edges, and possible azurophilic granulation (although not seen in this cell). Their single nucleus can be round or slightly oval to indented. |
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Term
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Definition
neutrophilic band
The neutrophilic band (#3) is the stage of development after the neutrophliic metamyelocyte (#2). The nucleus has indented and forms a "band" without any segmentation. The edges of the nucleus are practically parallel with each other. The cytoplasm contines to increase in the amount of specific granules with fewer azurophilic granules. |
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Term
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Definition
Niemann-Pick cell
The large cells with white, foamy cytoplasm are Niemann-Pick cells. They are histiocytes filled with lipid dropslets. Individuals with Niemann-Pick disease have a deficiency of sphingomyelinase and large accumulations of unmetabolized lipid sphingomyelin and cholesterol in their histiocytes. |
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Term
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Definition
chronic lymphocytic leukemia
Chronic lymphocytic leukemia is characterized by numerous small, dark lymphocytes that produce a "monotonous" blood picture. |
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Term
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Definition
| acute myelocytic leukemia - M1 |
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Term
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Definition
leukocyte alkaline phosphatase (LAP) stain
LAP stains for alkaline phosphatase enzyme activity in the cytoplasm of neutrophils. It is colored dark green/black in the preparation above. The stain is used to help differentiate between a leukemoid reaction and chronic myelocytic (granulocytic) leukemia. |
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Term
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Definition
lymphocyte - medium to large
Medium to large lymphocytes contain more cytoplasm than the small lymphcytes and can range in size from 10-14 microns. Their cytoplasm can be blue to gray and contain a few azurophilic granules |
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Term
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Definition
| acute myelocytic leukemia - M5A |
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Term
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Definition
Alder's anomaly
Leukocytes in Alder's anomaly have dark-staining, purplish-red granules that contain precipitated mucopolysaccharides. These granules are sometimes confused with toxic granules, which are not as large and usually stain a darker blue. Alder-Reilly inclusions are seen in Hurler's disease. Photo |
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Term
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Definition
prolymphocyte
A prolymphocyte (#1) is seen in this film with many mature lymphocytes (#2). Prolymphocytes are the stage of lymphocyte development following the lymphoblast stage. The nucleus of the prolymphocyte is younger in appearance than the nuclei of the mature lymphocytes. A large nucleolus is also seen in the prolymphocyte. |
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Term
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Definition
acute lymphocytic leukemia
ALL is characterized by lymphoblasts in the bone marrow and peripheral blood. Notice the immature chromatin, nucleoli, and high N:C ratio. |
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Term
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Definition
hyposegmentation (Pelger-Huet)
The heterozygous form of congenital Pelger-Huet has mature neutrophils (similar to the one in the picture above) that have a bi-lobed nucleus separated by a thin strand of nuclear material instead of the normal 3-5 lobed nucleus. The shape of the nucleus is often described as "dumbbell" or "pince-nez" (bifocal). |
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Term
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Definition
hairy cell
The nucleated "hairy cells" are found in hairy cell leukemia. Notice the streaming cytoplasmic processes. Photo© ASH/Univ. of WA hairy cell |
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Term
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Definition
toxic granulation
The neutrophil above contains numerous dark purple, cytoplasmic granules that are often seen in toxic situations such as bacterial infections. |
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