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CLS 307 > Lab Quiz 4 > Flashcards

Lab Quiz 4 Flashcards

1
Q

Where does a granulocyte come from, how many cell lines does it have, and name them

A

Bone marrow
3 cell lines
Neutrophilic, eosinophilic, basophilic

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2
Q

List the granulocyte lineage

A

Myeloblast → promyelocyte (progranulocyte) → myelocyte → metamyelocyte → band → segmented

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3
Q
A
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4
Q

Small cells (diameter 14um-18um)
Major part is occupied by a large oval nucleus
Chromatin is very fine, non-aggregated
2 or more nucleoli
Cytoplasm has basopholis character, devoid of granules

A

Myeloblast

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5
Q
A

Myeloblast

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6
Q

Primary (azurophilic) granules
Nucleus hidden by granules
Golgi zone and nucleoli may be visible
Approx. 2% of nucleated cells in BM
Don’t circulate in peripheral blood under normal conditions

A

Promyelocyte

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7
Q
A

Promyelocyte

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8
Q

Contain both primary and secondary/specific granules (secondary amount increases as cell matures)
Pink granules
Nucleus is round and lacks a nucleolus
Chromatin more condensed
Not normally present in peripheral blood
May be seen in infectious/inflammatory conditions, growth factor effect, marrow infiltration, and myeloid neoplasms

A

Myelocyte

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9
Q
A

Myelocyte

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10
Q

Condensed chromatin
Slightly indented nucleus
Abundant specific granules and rare primary granules
Not normally present in peripheral blood
Can be seen in infectious/inflammatory States, and other reactive and neoplastic conditions

A

Metamyelocyte

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11
Q
A

Metamyelocyte

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12
Q

Slightly less mature than segmented
Have indented, unsegmented “C” or “S” shaped nuclei
Approx. 5-10% of peripheral blood leukocytes
An increase can indicate infection and inflammation

A

Bands

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13
Q
A

Bands

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14
Q
A

Segmented granulocytes

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15
Q

Mature granulocytes with condensed chromatin
2-5 nuclear lobes separated by thin filaments
Cytoplasm = pale pink, numerous specific granules
40-80% of peripheral blood leukocytes

A

Segmented granulocytes

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16
Q

Has 6 or more nuclear lobes
Typically seen in megaloblastic anemia due to vitamin B12 of folic acid deficiency
May also be present in myelodysplastic syndromes and rare congenital conditions

A

Hypersegmentation

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17
Q
A

Hypersegmentation

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18
Q

Rare autosomal dominant disorder
Caused by failure of nuclear segmentation due to genetic defect
Heterozygous have dumbbell-shaped or hyposegmented neutrophils with coarse chromatin and normal granules
Homozygous have neutrophils with a single, round, eccentric nucleus with clumped chromatin and no nuclear segmentation
Benign condition

A

Pelger-Huet anomaly

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19
Q
A

Pelger-Huet anomaly

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20
Q

An acquired abnormality due to myelodysplastic disorders, myeloproliferative diseases, and acute and chronic leukemia’s, reactions to drugs, and so on.
Drug induced tends to have monolobated neutrophils with a single ovoid nucleus
Myelodysplastic syndrome tends to be bi-lobed neutrophils

A

Pseudo Pelger-Huet anomaly

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21
Q
A

Pseudo Pelger-Huet anomaly

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22
Q

Autosomal dominant abnormality characterized by large pale basophilic inclusions resembling Dohle bodies which appear to be altered RNA
Giant platelets and sometimes thrombocytopenia

A

May-hegglin anomaly

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23
Q
A

May-hegglin anomaly

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24
Q

Rare autosomal recessive disorder
Partial oculocutaneous albinism due to defects in melanin granules and recurrent pyogenic bacterial infections due to abnormalities in granulocytes
Basic defect is in microtubules resulting in fusion of lysosomal granules
All WBCs contain abnormally giant granules
Azurophilic granules form and fuse together to form mega granules

A

Chediak-Higashi syndrome

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25
Q
A

Chediak-Higashi syndrome

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26
Q

Caused by the deficiency of one of ten lysosomal enzymes and the resultant accumulation of glycosaminoglycans in tissues and organs
Evenly distributed granulocytes show metachromatic and darkly staining inclusions that resemble toxic granulation but are permanent
Gargoylism and dwarfish
Can be neurological impairments, vision, hearing, and developmental issues
Tay-sachs, Hunter syndrome

A

Alder-reilly anomaly

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27
Q
A

Alder-reilly anomaly

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28
Q
A

Alder-Reilly anomaly

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29
Q

Rare genetic disorder
Deposition of glucocerebroside in cells of the macrophage-monocyte system
Disorder results from the deficiency of the enzyme glucocerobrosidase
Lipid storage problem

A

Gaucher Cell

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30
Q
A

Gaucher cell

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31
Q

Lysosomal storage disease that affects metabolism and caused by genetic mutations
Some not able to metabolize cholesterol and other lipids property within the cell
Others have a deficiency of a specific enzyme, acid sphingomyelinase

A

Niemann-pick disease

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32
Q
A

Niemann-pick cells

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33
Q

Develop when a series of acquired genetic mutations take place within the bone marrow compartment leading to a proliferation of clones of abnormal stem cells

A

Myeloproliferative disorders (neoplasm)

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34
Q

Peripheral blood demonstrates neutrophilia with prominent left shift, eosinophilia, and basophilia
Typically numerous myelocytes and segmented neutrophils predominate
Dark primary granules, metamyolocytes, band neutrophils

A

Chronic myelogenous leukemia

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35
Q
A

Chronic myelogenous leukemia

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36
Q

Very high WBC count and immature WBC (blasts, promyelocytes, myelocytes, and metamyelocytes)
Often have anemia or thrombocytopenia
Band neutrophils, increase in basophils and eosinophils

A

Chronic myelogenous leukemia

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37
Q
A

Chronic myelogenous leukemia

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38
Q
A

Chronic myelogenous leukemia

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39
Q

Solid green arrows = atypical monocytes, they are slightly larger and show a decreased lobularity of the nucleus
Dotted green arrow = large promonocyte
Solid yellow arrows = hypogranular/agranular segmented neutrophils
Dotted yellow arrow = band neutrophil
White arrows = myelocyte with lower amount of cytoplasm
Cyan arrow= a megaloblastoid metamyelocyte with hypogranular cytoplasm

A

Chronic myelomonocytic leukemia (CMML)

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40
Q

Condition where peripheral WBCs on a stained blood smear may have some resemblance to leukemia cells
High neutrophil count with more immature cells, particularly myelocytes
High leukocyte alkaline Phosphatase score
Metamyelocytes, neutrophils

A

Leukemoid reaction

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41
Q
A

Leukemoid reaction

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42
Q

What disease?

A

Leukemoid reaction

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43
Q

Used to differentiate chronic leukemia vs leukemoid reaction
An enzyme present in the secondary granules of neutrophils and not present in eosinophils or basophils
Each cell is assigned a score between 0-4 (0 = no stain retained, 4 = very dark)
Scores of each cell are added up which give a potential score 0-400

A

Leukocyte alkaline phosphatase (LAP)

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44
Q
A

Leukocyte alkaline phosphatase

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45
Q

Normal morphology
Increase in RBCs, granulocytic WBCs, platelets, hemoglobin, and hematocrit

A

Polycythemia Vera

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46
Q
A

Polycythemia Vera

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47
Q

Sustained and pronounced thrombocythemia
Increased megakaryocytes in marrow
Increased WBC, occasionally metamyelocytes and myelocytes present

A

Essential thrombocythemia

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48
Q
A

Essential thrombocythemia

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49
Q

Fibrosis of marrow cavity
Extramedullary hematopoesis
Smear may show nRBC, immature granulocytes, micromegakaryocytes
Tear drop cells

A

Primary myelofibrosis

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50
Q
A

Primary myelofibrosis

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51
Q

Acute myeloblastic leukemia, minimally differentiated

A

Acute myelogenous leukemia M0

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52
Q

Acute myeloblastic leukemia, without maturation

A

Acute myelogenous leukemia M1

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53
Q

Acute myeloblastic leukemia, with granulocytic maturation

A

Acute myelogenous leukemia M2

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54
Q

Promyelocytic, or acute promyclocytic leukemia (APL)

A

Acute myelogenous leukemia M3

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55
Q

Acute myelomonocytic leukemia

A

Acute myelogenous leukemia M4

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56
Q

Myelomonocytic together with bone marrow eosinophilia

A

Acute myelogenous leukemia M4eo

57
Q

Acute monoblastic leukemia (M5a) or acute monocytic leukemia (M5b)

A

Acute myelogenous leukemia M5

58
Q

Acute erythroid leukemias, including erythroleukemia (M6a) and very rare pure erythroid leukemia (M6b)

A

Acute myelogenous leukemia M6

59
Q

Acute megakaryoblastic leukemia

A

Acute myelogenous leukemia M7

60
Q

This stains is an enzyme that is found in the primary grandes of all granulocytes and monocytes and not present in lymphocytes
Useful for differentiating between ALL and AML
Positive stain for acute myeloid leukemias M1, M2, M3, M4
Stains lipids present in the primary and secondary granules of granulocytes and monocyte lysosomes

A

Myeloperoxidase (MPO)

61
Q

What stain is present

A

Myeloperoxidase (MPO)

62
Q

Non-specific - used to differentiate granulocytes from monocytes
Specific - specific for granulocytes (myeloblasts)

A

Esterase stains

63
Q

What stain is used

A

Esterase stain

64
Q

Lack of obvious myeloid differentiation
Presence of myeloperoxidase in <3% of blasts
Blasts are small to large with no granules or auer rods
Blasts contain evenly distributed chromatin and prominent nucleoli
Appear similar to lymphoblasts

A

Acute minimally differentiated myeloid leukemia (AML-M0)

65
Q

What disease shows myeloblasts that are larger than a small lymphocyte and does not show prominent nucleoli

A

Lymphoblastic leukemia

66
Q

What disease

A

Acute minimally differentiated myeloid leukemia (AML-M0)

67
Q

Presence of more than 90% myeloblasts in blood and/or bone marrow
Most blasts are large with prominent nucleoli

A

Acute myeloblastic leukemia with minimal maturation (AML-M1)

68
Q

What disease

A

Acute myeloblastic leukemia with minimal maturation (AML-M1)

69
Q

Presents with greater than 20% blasts, at least 10% maturing cells of neutrophil lineage, and fewer than 20% precursors with monocytic lineage
Auer rods and other aspects of dysplasia are present
Abnormal shapes and primary granules starting

A

Acute myeloblastic leukemia with maturation (AML-M2)

70
Q

What disease

A

Acute mydoblastic leukemia with maturation (AML-M2)

71
Q

Predominance of promyelocytes
Abundance of purple granules
Some have “bundles of auer rods”
Promyelocytes have abnormally coarse and numerous azurophilic granules
Several cells have bi-lobed nuclei (angel wings) and a cell in the center of the field contains multiple needle-like auer rods

A

AML-M3
Acute promyelocytic leukemia (APL)

72
Q

What disease

A

AML M3
Acute promyelocytic leukemia (APL)

73
Q

Myeloid and monocytic cells are present
Monocytic cells comprise at least 20% of all marrow cells, with monoblasts and promonocytes present

A

Acute myelomonocytic Leukemia (AML M4)

74
Q

What is M4 eos

A

Acute myelomonocytic leukemia with eosinophilia

75
Q

What disease

A

Acute myelomonocytic leukemia (AML M4)

76
Q

More than 20% monoblasts and/or promonocyte cells in bone marrow
Large monoblasts with fine nuclear chromatin and prominent nucleoli
Absence of auer rods
Promonocytes show moderate amounts of cytoplasm and large nuclei with five chromatin but without prominent nucleoli
Presence of nuclear folds and creases

A

Acute monoblastic-monocytic leukemia (AML M5)

77
Q

What disease

A

Acute monoblastic - monocytic leukemia (AML M5)

78
Q

What kind of cell is the arrow pointing at?
What disease

A

Nucleated RBC (nRBC)
Erythroleukemia (AML-M6)

79
Q

What disease

A

Acute basophilic leukemia (AML M8)

80
Q

Lymphocytes are small but slightly larger than normal small lymphocytes and show scant cytoplasm and round to slightly irregular nuclei contains clumped chromatin
Nucleoli are small to indistinct
Presence of “smudge” or “basket” cells

A

B-cell chronic lymphocytic leukemia (CLL)

81
Q

What disease

A

B-cell chronic lymphocytic leukemia (CLL)

82
Q

Medium-sized lymphocytes with prominent single nucleoli, with a moderate amount of pale weakly basophilic cytoplasm, and somewhat condensed chromatin
What disease?

A

Chronic lymphocytic leukemia (CLL) with prolymphocyte transformation / prolymphocytic leukemia

83
Q

What disease

A

Chronic lymphocytic leukemia (CLL) with prolymphocyte transformation / prolymphocytic leukemia

84
Q

What type of Acute Lymphocytic Leukemia (ALL):
T cell or pre-B cell
Small and homogeneous (uniform) cells

A

ALL - L1

85
Q

What type of Acute Lymphocytic Leukemia (ALL):
T cell or pre-B cell
Large and heterogeneous (varied) cells

A

ALL - L2

86
Q

What type of Acute Lymphocytic Leukemia (ALL):
B cell
Large and varied cells with vacuoles

A

ALL - L3

87
Q

Mostly B cells
Blasts have:
Minimal cytoplasm
Variable nuclear size and chromatin density
Irregular nuclear contour
Some small nucleoli

A

Acute lymphocytic leukemia L1

88
Q

What disease

A

Acute lymphocytic leukemia L1

89
Q

Blasts have:
Moderate cytoplasm
Round nuclei of variable size
Coarse chromatin
Some resemble mature lymphocytes
Not noticeable nucleoli

A

Acute lymphocytic leukemia L1

90
Q

What disease

A

Acute lymphocytic leukemia L1

91
Q

Large lymphoblasts have:
Moderate cytoplasm
Large nuclei with hoarsely reticular chromatin
Prolymphocytic transformation

A

Acute lymphocytic leukemia L2

92
Q

What disease

A

Acute lymphocytic leukemia L2

93
Q

Blasts have cytoplasmic azurophilic granules (uncommon)

A

Acute lymphocytic leukemia L2

94
Q

What disease

A

Acute lymphocytic leukemia L2

95
Q

Blasts:
Vary in size, small to large
May contain very scant to moderate amounts of cytoplasm and is a darker blue color
May be heterogeneous with respect to the amount of cytoplasm, nuclear size, and presence or absence of distinct nucleoli
Cytoplasmic vacuoles may be seen

A

Acute lymphocytic leukemia L3

96
Q

What is a characteristic feature of Burkina lymphoma/leukemia and is related to the Epstein-Barr virus

A

The presence of cytoplasmic vacuoles

97
Q

What disease

A

Acute lymphocytic leukemia L3

98
Q

AKA Burkitt lymphoma
Tumor cells have moderate amounts of deeply basophilic cytoplasm with numerous lipid vacuoles

A

Acute lymphocytic leukemia L3

99
Q

What disease

A

Acute lymphocytic leukemia L3

100
Q

What is a group of malignancies that develop from lymphocytes, they originate in lymphoid tissue and spread to the bone marrow and other tissues over time

A

Lymphoma

101
Q

What are the two main types of lymphoma

A

Hodgkin lymphoma and Non-Hodgkin lymphoma

102
Q

Name the disease:
Malignant cells usually have B-cell markers
Associated with epstein-barr virus
Reed-sternberg cells in bone marrow

A

Hodgkin’s lymphoma

103
Q

What disease

A

Hodgkin’s lymphoma

104
Q

Seen in a bone marrow specimen with twin nuclei and prominent nucleoli
Clear area around the nucleoli with H&E stain, giving “owl’s eyes”

A

Reed sternberg cells

105
Q

What type of cell

A

Reed sternberg cells

106
Q

Rare b-cell lymphoproliferative disorder usually seen in middle-aged men
Shows the circumferential cytoplasmic ”fuzzy” projections (arrow)
Moderate light to pale blue cytoplasm

A

Hairy cell leukemia

107
Q

What disease

A

Hairy cell leukemia

108
Q

An aggressive form of lymphoma called cutaneous T-cell lymphoma. Cells are present in the blood, skin, and lymph nodes
Abnormally shaped nucleus

A

Sezary syndrome

109
Q

What type of cell

A

Sezary cells

110
Q

Intermediate to large sized lymphoid cells with irregular nuclei, dispersed chromatin, prominent nucleoli, and small amounts of cytoplasm

A

T-cell lymphoblastic lymphoma

111
Q

Circulating lymphoma cells may be pleomorphic with basophil cytoplasm resembling blasts
Vary in size

A

Large B-cell lymphoma

112
Q

Cells with cleaved nucleus and paucity of cytoplasm
What disease?

A

Mantle cell lymphoma

113
Q

What cell

A

Plasma cell

114
Q

Plasma cells with multiple cytoplasmic globules present in a single cell
Seen in some parasitic infections, malaria, leishmaniasis, trypanosomiasis, myeloma

A

Mott cells
Grape cell or morula cell

115
Q

The term for individual inclusion/globule in a Mott cell

A

Russell body

116
Q

Nuclear inclusions in Mott cells

A

Dutcher bodies

117
Q

Plasma cells with a distinctive pinkish hue in the outer rim of the cytoplasm
Cells found in plasma cell dyscrasias as well as cases of chronic infection or inflammation

A

Flame cell

118
Q

What cell

A

Flame cell

119
Q

Varies from small mature-appearing plasma cells to large anaplastic cells without any apparent resemblance to plasma cells
Show “clonal” morphology

A

Multiple myeloma

120
Q

Cells with crystalline inclusions
Forms include needle-like, coarse, azurophilic granules, prismatic, spindle shaped, spherical, and cylindrical shape
What disease?

A

Multiple myeloma

121
Q

Yellow arrow = small lymphocyte
Two arrowheads = two plasma cells
Two long arrows = two plasmacytoid lymphocytes
What disease?

A

Waldenstrom’s macroglobulinemia

122
Q

Contains small lymphocytes, plasma cells, and plasmacytoid lymphocytes (constant feature)
Can have rouleaux formation
What disease

A

Waldenstrom’s macroglobulinemia

123
Q

Eccentric nuclei that protrudes from the cell and a pale hoff that is not adjacent to the nucleus
What kind of cell?

A

Osteoblast

124
Q

How are thrombocytes generated

A

Start in bone marrow → stem cell → common myeloid progenitor → megakaryocyte - erythrocyte progenitor → megakaryoblast → promegakaryocyte → megakaryocyte → platelet

125
Q

Large cell about 20-30 micrometers in bone marrow
Has a single oval or kidney- shaped nucleus, several nucleoli, and basophilie non-granular cytoplasm

A

Megakaryoblast

126
Q

Large cell about 20-30 micrometers in bone marrow
Single oval or kidney - shaped nucleus, several nucleoli and basophilic non-granular cytoplasm
What cell

A

Megakaryoblast

127
Q

More abundant cytoplasm
Cytoplasm is less basophilic and may begin to show azurophilic granulation
Nucleus becoming irregular even lobed in shape
Multiple nucleoli present
Still in bone marrow
What cell

A

Promegakaryocyte

128
Q

Large cell, round or oval. 20-80 micrometers. In bone marrow
Cytoplasm appears lumpy, basophilic, with azurophilic granules
Chromatin is dense and multi-lobed

A

Basophilic megakaryocyte

129
Q

Large cell 35-160 micrometers in diameter. Round or oval, often has unclear contour. In bone marrow
Edges are slightly basophilic or colorless
Filled with markedly red or bluish-red granules
Lobed condensed nucleus sometimes with separated lobuli
What cell

A

Acidophilic megakaryocyte

130
Q

Large, round to oval cell 35 - 160 micrometers. In bone marrow
Cytoplasm is slightly reddish to colorless with clusters of azurophilic granules
Produces between 2000 - 7000 thrombocytes, which can be seen breaking off along the margins of the cell
Nucleus is irregular s often fragmented and pyknotic with denser chromatic

A

Thrombocytogenic megakaryocyte

131
Q

What cell?

A

Megakaryocyte nuclei

132
Q

15-30 micrometers
Nuclear chromatin may appear smudged or puddled looking
What cell?

A

Micromegakaryocyte

133
Q

Rare autosomal recessive disorder
Giant hyper granular platelets with granules condensed in center creating a “pseudo-nucleus”
What disease?

A

Bernard - soulier syndrome

134
Q

Normal to giant in size
Round, oval or irregular in shape, have surface projections
Cytoplasm is light gray to light blue
Contain rare azurophilic granules
What cell

A

Hypo granular platelet

135
Q

Rare inherited disorder (autosomal recessive)
Moderate thrombocytopenia and agranular platelets
Platelets lack granules and appear as gray or pale blue splotches
What disease

A

Gray platelet syndrome

136
Q

May occur as the result of partial clotting from not properly and promptly mixing the specimen or if the blood draw is poorly performed
Can cause pseudo-thrombocytopenia

A

Platelet clumps/aggregation

137
Q

Can cause pseudo-thrombocytopenia
Result of an IgG plasma antibody coating platelets in the presence of EDTA. The platelets then rosette around segmented neutrophils, bands, and monocytes

A

Platelet satellitism

138
Q

Nuclei with multiple overlapping lobes

A

Megakaryocyte

CLS 307 (21 decks)

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