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Week 6: Cell Morphology

Wright stain RBC morphology Anisocytosis Poikilocytosis WBC morphology. WBC differentials Artifacts. Week 6: Cell Morphology. Wright Stain. Romanowsky stain family Polychromatic Absolute methanol fixative Methylene blue - basophilic components Eosin - acidophilic components.

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Week 6: Cell Morphology

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  1. Wright stain RBC morphology Anisocytosis Poikilocytosis WBC morphology WBC differentials Artifacts Week 6: Cell Morphology

  2. Wright Stain • Romanowsky stain family • Polychromatic • Absolute methanol fixative • Methylene blue - basophilic components • Eosin - acidophilic components

  3. Smear Making • Essential in morphology • Wedge method • Thickness and length

  4. Key Features • Size • Nuclear shape • Chromatin features • Granules and other inclusions • Color

  5. Leukocytes • Granulocytes: have specific granules • Eosinophil • Basophil • Neutrophil • Non-granulocytes • Lymphocyte • Monocyte

  6. Granulocytes • Eosinophil • Large orange granules • <2% in circulation • Usually bilobed • Increased in allergy, parasites

  7. Granulocytes • Basophil • Large black-purple granules • <1% in circulation • Increased in allergy, CML

  8. Granulocytes • Segmented Neutrophil • Small purple granules • 54-62% in circulation • Coarse chromatin • Increased in bacterial infection • Band • No nuclear filament • 3-5% in circulation • Increased in bacterial infection

  9. Non-Granulocytes • Lymphocyte • Relatively small • Round or oval nucleus • Smudged chromatin • Basophilic cytoplasm • Increased in viral infection • 25 - 33% (more in children)

  10. Non-Granulocytes • Monocyte • Relatively large • Grey cytoplasm with vacuoles • Irregular nucleus • Linear chromatin • Increased in chronic infection • 3 - 7%

  11. Platelets • Cytoplasmic fragments of large megakaryocyte • 2-3 mm in diameter with granules • Promotes clot formation • 8-20 per oil immersion field • 150,000 - 400,000/mL

  12. Erythrocyte Morphology • Normal: biconcave disc of 7.5 mm diameter • Has central pallor (1/3 of diameter) on smear • No inclusions

  13. Good Area to Evaluate Morphology

  14. Anisocytosis: Variation in Size Microcytes Macrocytes

  15. Poikilocytosis: Abnormal Shape Target Cells Hypochromic

  16. Poikilocytosis Schistocyte Sickle Cell

  17. Poikilocytosis Teardrop Cell Spherocyte

  18. Poikilocytosis Elliptocyte Stomatocyte

  19. RBC Inclusions, etc. Polychromasia Howell-Jolly Bodies

  20. RBC Inclusions Cabot Ring Basophilic Stippling

  21. RBC Inclusions, etc. Malaria Rouleaux

  22. Too Thick Too Alkaline Too Thin Too Acidic

  23. Unacceptable Slides

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