Review of PB and BM Morphology - NON-Malignant Flashcards
Characteristics of normal myeloblast?
- Size: Med to large size
- High N:C ratio
- Cytoplasm: granules often
- Nucleus: Open chromatin, often prominent nucleoli
Characteristics of promyelocyte?
- Size: Large
- Cytoplasm: Primary granules
- Nucleus: Large with open chromatin and prominent nucleoli
Characteristics of myelocyte?
- Nucleus: Starts to condense
- Cytoplasm: Primary granules replaced by secondary granules
Characteristics of metamyelocyte?
-Nucleus: Continues to condense, starts to indent
Characteristics of band?
- Size: small
- Nucleus: has not undergone segmentation yet
Characteristics of mature neutrophil?
-Nucleus: 3-5 nuclear lobes
Common reactive changes in neutrophilcs seen in inflammatory situations?
-Associated with which situations?
- Toxic granulation = accentuated cytoplasmic granulation
- Cytoplasmic vacuolization often wth granulation
-Can be associated with infections, burns, trauma, cytokine administration (G-CSF)
What is a Dohle Body?
- Reactive finding - generally seen in association with toxic changes (associated with infections, burns, trauma, cytokine admin (G-CSF))
- Bluish inclusion of variable size and shape n cytoplasm of neutrophil
- Represents remnants of the rough endoplasmic reticulum
How is a giant platelet characterized?
Larger than a red cell
What is the May-Hegglin anomaly?
-Caused by mutations in myosin heavy chain 9 (MHY9-related disorder)
What are the peripheral blood findings in May-Hegglin anomaly?
- Neutrophils with prominent Dohle-body-like cytoplasmic inclusions
- Giant or large platelets (Macrothrombocytopenia with normal granulation)
- Thrombocytopenia
- Normal hemoglobin/hematocrit
Some examples of MHY-9 related diseases?
- Epsteim syndrome
- Fechtner syndrome
- May-Hegglin anomaly
What are the macrothrombocytopenias and their genetic association?
- Bernard-Soulier (GP-1Ba)
- Grey Platelet Syndrome (NBEAL2)
- vWF type 2b
- Paris-Trousseau thrombocytopenia (deletion of 11q23-terminus)
Inheritance of Chediak-Higashi Syndrome? Etiology?
- Autosomal recessive (rare)
- Due to abnormal lysosomal biogenesis, which is secondary to missense or nonsense mutations in CHS/LYST gene
Phases and features of Chediak-Higashi Syndrome?
- Stable phase: Increased susceptibility to infection, occulocutaneous albinism
- Accelerated phase: HLH, typically fatal
Peripheral blood smear in Chedak-Higashi Syndrome?
- Abnormally large azurophilic or grey granules in the neutrophils
- T-cells with enlarge mature cytolytic secretory granules (do not function properly)
- Granules stain positive for myeloperoxidase and acid phosphatase
Peripheral blood film showing neutrophils with bilobed nuclei and normal cytoplasmic granulation? Genetic cause? Morphologic difference in heterozygotes and homozygotes?
- Pelger-Huet anomaly
- Caused by mutations in the Lamin B receptor
- Heterozygotes: bilobed neutrophils (100%)
- Homozygotes: Neutrophils with round unilobed nuclei (no nuclear segmentation can occur at all)
Causes of bilobed morphology other than Pelger-Huet anomaly (acquired causes)? Technical term?
- Myelodysplastic syndrome
- Medications
- Infection
- “Pseudo Pelger-Huet cells” - not all cells on smear
What is the Alder-Reilly anomaly? What conditions is it seen in?
- Prominent azurophilic granulation in leukocytes, including lymphocytes and monocytes
- Seen in patients with mucopolysaccharidoses where there is lysosomal buildup of mucopolysaccharide due to impaired catabolism
What are hematogones? Characteristics?
- Immature B cells
- Dense nuclei
- High N:C ratio
Morphologic characteristics of mature lymphs?
- More ample cytoplasm
- Clumped nuclear consistency/chromatin (vs. dense and smooth)
- Round nuclei
Differentiating reactive/atypical lymph vs. monocyte?
- Mostly round nucleus in reactive/atypical lymph
- “Skirting” in reactive lymph
Morphologic findings on smear in bordetella pertussis infections?
- Small, mature lymphocytosis (secondary to release of pertussis toxin)
- Some lymphocytes have prominent nuclear clefting
