LEUKOCYTE MORPHOLOGICAL ABNORMALITIES (GCA) Flashcards
Darkly staining metachromatic (purple-red) cytoplasmic granules in granulocytes (less often in monocytes and lymphocytes
ALDER-REILLY GRANULES (primary granules)
Abnormal large primary granules
ALDER-REILLY GRANULES (primary granules)
Granules contain degraded mucopolysaccharides due to an enzyme defect
ALDER-REILLY GRANULES (primary granules)
May resemble toxic granules (seen in infections and toxic states)
ALDER-REILLY GRANULES (primary granules)
Alder-Reilly anomaly Mucopolysaccharidoses (MPSs’)
ALDER-REILLY GRANULES (primary granules)
-Gray-blue spindle shaped inclusions in the cytoplasm
MAY-HEGGLIN GRANULES
-Large Dohle body-like inclusions in neutrophils,eosinophils, basophils, and monocytes
MAY-HEGGLIN GRANULES
-The basophilic Dohle body-like leukocyte inclusions are composed of precipitated myosin heavy chains (mRNA)
MAY-HEGGLIN GRANULES
-True Dohle bodies consist of lamellar rows of rough endoplasmic reticulum (rRNA)
MAY-HEGGLIN GRANULES
Giant red, blue, to grayish round inclusions in the cytoplasm
CHEDIAK-HIGASHI GRANULES
Giant lysosomal granules in granulocytes, monocytes,and lymphocytes
CHEDIAK-HIGASHI GRANULES
Cells in the body are affected and exhibit abnormally large lysosomes, which contain fused dysfunctional granules
CHEDIAK-HIGASHI GRANULES
are cytoplasmic inclusions that resemble the fused lysosomal granules
Pseudo-Chediak-Higashi granules
All cancerous
Chediak-higashi granules
Pink or red shaped cytoplasmic granules; found in myeloid and monocytic series only Fused primary granules (peroxidase stain positive)
AUER RODS
bundle of auer rods (seen in acute promyelocytic leukemia(APL); M3; also associated with DIC)
Faggot Cells
Acute myelogenous leukemia (AML, M1 and M2) Acute promyelocytic leukemia (APL, M3) Acute myelomonocytic leukemia (AMML, M4) [AML 1-7]
AEUR RODS
-Appears as dark, blue-black granules in the cytoplasm of neutrophils, usually in segmented and band forms
TOXIC GRANULATION (primary/reactive granules)
-Granulation may represent the precipitation of ribosomal protein (RNA) caused by metabolic toxicity within the cells
TOXIC GRANULATION (primary/reactive granules)
Are peroxidase positive and reflect an increase in acid mucosubstance within primary, azurophilic granules that may enhance bactericidal activity
TOXIC GRANULATION (primary/reactive granules)
Scale of toxic granulation?
1+ to 4+
what is the severe scale in toxic granulation?
4+
WHAT CAN TOXIC GRANULATION CAN MIMIC?
ALDER-REILLY ANOMALY
Inflammations Infections Toxic states Burns Malignant disorders
Toxic Granulation
Are light/pale blue round or elongated cytoplasmic inclusions between 1-5 um consisting of remnants of ribosomal ribonucleic acid (rRNA) arranged in parallel row; close to cellular membranes
DOHLE-AMATO BODIES/DOHLE BODIES
-Are typically found in band and segmented neutrophils and can appear together with toxic granulations; can be seen in eosinophils, basophils, monocytes, and lymphocytes
DOHLE-AMATO BODIES/DOHLE BODIES
Localized failure of cytoplasmic maturation
DOHLE-AMATO BODIES/DOHLE BODIES
which granulocytes cytoplasmic abnormalities has a PAS reaction positive
DOHLE-AMATO BODIES/DOHLE BODIES
which granulocytes cytoplasmic abnormalities may be confused with May-Hegglin granules
DOHLE-AMATO BODIES/DOHLE BODIES
-A delay in preparing the blood film after collection may affect Dohle body appearance in that they are more grey than blue or in some cases may not be visible
DOHLE-AMATO BODIES/DOHLE BODIES
which granulocytes cytoplasmic abnormalities can be seen in pregnant patients?
DOHLE-AMATO BODIES/DOHLE BODIES
Autophagocytic vacuoles Tend to be small
CYTOPLASMIC VACUOLATIONS (holes/vacuoles)
Tend to be large (up to 6 um) and often accompanied by toxic granulation induced by either bacteria or fungi are suggestive of sepsis
phagocytic vacuoles
water has been lost and the chromatin becomes dense and -dark
PYKNOTIC AND NECROTIC CELLS
i in neutrophils generally indicate imminent cell death In a pyknotic nucleus
pyknotic nuclei
-Increased numbers of pyknotic or necrotic cells suggest that an
extended amount of time has elapsed between blood collection and blood film preparation
-Necrotic nuclei are found in
dead neutrophils/necrobiotic neutrophils; they are rounded nuclear fragments with no filaments and no chromatin pattern
-Is a result of osmotic swelling of the cytoplasm or by increased adhesion to the glass slide in stimulated neutrophils
CYTOPLASMIC SWELLING
-Regardless of the cause, the result is a variation in neutrophil size or neutrophil anisocytosis
CYTOPLASMIC SWELLING
Are small, obligate, intracellular bacteria transmitted by ticks to humans and other vertebrate hosts
EHRLICHIA AND ANAPLASMA
These organisms grow as a cluster (morulae) in neutrophils and monocytes
EHRLICHIA AND ANAPLASMA
can be mistaken for Dohle bodies in neutrophils can be mistaken for Dohle bodies in neutrophils
Morulae(cluster)
Anaplasma phagocytophilum and rarely in
Ehrlichia ewingii (neutrophils)
is transmitted by the black-legged tick (Ixodes scapularis) and the western black-legged tick (I. pacificus)
Human granulocytic erlichiosis(HGE)
is a fungus; this organism lives intracellularly in cells of the mononuclear phagocyte system, cells of the bone marrow, or cells from sputum or effusion specimens
HISTOPLASMA (gardening)
H. capsulatum
The fungus appears as a tiny oval body with a clear halo surrounding a small nucleus
HISTOPLASMA (gardening)
