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ASPHO Lectures 2021 > Review of PB and BM Morphology - NON-Malignant > Flashcards

Review of PB and BM Morphology - NON-Malignant Flashcards

1
Q

Characteristics of normal myeloblast?

A
  • Size: Med to large size
  • High N:C ratio
  • Cytoplasm: granules often
  • Nucleus: Open chromatin, often prominent nucleoli
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2
Q

Characteristics of promyelocyte?

A
  • Size: Large
  • Cytoplasm: Primary granules
  • Nucleus: Large with open chromatin and prominent nucleoli
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3
Q

Characteristics of myelocyte?

A
  • Nucleus: Starts to condense

- Cytoplasm: Primary granules replaced by secondary granules

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4
Q

Characteristics of metamyelocyte?

A

-Nucleus: Continues to condense, starts to indent

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5
Q

Characteristics of band?

A
  • Size: small

- Nucleus: has not undergone segmentation yet

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6
Q

Characteristics of mature neutrophil?

A

-Nucleus: 3-5 nuclear lobes

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7
Q

Common reactive changes in neutrophilcs seen in inflammatory situations?
-Associated with which situations?

A
  • Toxic granulation = accentuated cytoplasmic granulation
  • Cytoplasmic vacuolization often wth granulation

-Can be associated with infections, burns, trauma, cytokine administration (G-CSF)

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8
Q

What is a Dohle Body?

A
  • 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
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9
Q

How is a giant platelet characterized?

A

Larger than a red cell

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10
Q

What is the May-Hegglin anomaly?

A

-Caused by mutations in myosin heavy chain 9 (MHY9-related disorder)

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11
Q

What are the peripheral blood findings in May-Hegglin anomaly?

A
  • Neutrophils with prominent Dohle-body-like cytoplasmic inclusions
  • Giant or large platelets (Macrothrombocytopenia with normal granulation)
  • Thrombocytopenia
  • Normal hemoglobin/hematocrit
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12
Q

Some examples of MHY-9 related diseases?

A
  • Epsteim syndrome
  • Fechtner syndrome
  • May-Hegglin anomaly
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13
Q

What are the macrothrombocytopenias and their genetic association?

A
  • Bernard-Soulier (GP-1Ba)
  • Grey Platelet Syndrome (NBEAL2)
  • vWF type 2b
  • Paris-Trousseau thrombocytopenia (deletion of 11q23-terminus)
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14
Q

Inheritance of Chediak-Higashi Syndrome? Etiology?

A
  • Autosomal recessive (rare)

- Due to abnormal lysosomal biogenesis, which is secondary to missense or nonsense mutations in CHS/LYST gene

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15
Q

Phases and features of Chediak-Higashi Syndrome?

A
  • Stable phase: Increased susceptibility to infection, occulocutaneous albinism
  • Accelerated phase: HLH, typically fatal
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16
Q

Peripheral blood smear in Chedak-Higashi Syndrome?

A
  • 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
17
Q

Peripheral blood film showing neutrophils with bilobed nuclei and normal cytoplasmic granulation? Genetic cause? Morphologic difference in heterozygotes and homozygotes?

A
  • 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)
18
Q

Causes of bilobed morphology other than Pelger-Huet anomaly (acquired causes)? Technical term?

A
  • Myelodysplastic syndrome
  • Medications
  • Infection
  • “Pseudo Pelger-Huet cells” - not all cells on smear
19
Q

What is the Alder-Reilly anomaly? What conditions is it seen in?

A
  • 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
20
Q

What are hematogones? Characteristics?

A
  • Immature B cells
  • Dense nuclei
  • High N:C ratio
21
Q

Morphologic characteristics of mature lymphs?

A
  • More ample cytoplasm
  • Clumped nuclear consistency/chromatin (vs. dense and smooth)
  • Round nuclei
22
Q

Differentiating reactive/atypical lymph vs. monocyte?

A
  • Mostly round nucleus in reactive/atypical lymph

- “Skirting” in reactive lymph

23
Q

Morphologic findings on smear in bordetella pertussis infections?

A
  • Small, mature lymphocytosis (secondary to release of pertussis toxin)
  • Some lymphocytes have prominent nuclear clefting

ASPHO Lectures 2021 (10 decks)

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