WBC and Platelet Progression Flashcards
Platelet Progression
1) HSC (stem cell)
2) Common myeloid progenitor
3) Megakaryocyte - erythrocyte progenitor
4) Megakaryoblast MK-I
5) Promegakaryocyte MK-II
6) Megakaryocyte MK-III
7) Platelets
Megakaryocyte Blast
Nucleus is round
2-6 Nucleoli
Chromatin is homogeneous, loosely organized
Cytoplasm is basophilic
N:C ratio is 3:1
Bone marrow - if found in peripheral - send for path review
Promegakaryocyte
Nucleus is indented
Nucleoli is variable
Chromatin is condensed
Cytoplasm is basophilic
N:C ratio is 1:2
Bone marrow - if found in peripheral - send for path review
Megakaryoctye
Nucleus has 2 to 32 lobes (8 most common)
Cytoplasm is blue to pink and abundant
Bone marrow - if found in peripheral - send for path review
Platelet
Usually small (2 - 4 um)
No nucleus
Cytoplasm is light blue to colorless
Normal range is 7 to 25/opf
Note any large or giant size in case - could falsely increase WBC count
White Blood Cell Progression Granulocytes
1) HSC (stem cell)
2) Common myeloid progenitor
3) Granulocyte - monocyte progenitor
4) Myeloblast
5) Promyelocyte
6) Myelocyte - last stage for mitotic pool
7) Metamyelocyte
8) Band
9) Mature granulocyte
White Blood Cell Progression Monocytes
1) HSC (stem cell)
2) Common myeloid progenitor
3) Granulocyte - monocyte progenitor
4) Monoblast
5) Promonocyte
6) Monocyte - peripheral blood
7) Macrophage - tissue
Myeloblast (commonly called Blast)
Unable to differentiate between different blast cell lines
Nucleus is round to oval
2-5 Nucleoli
Chromatin is fine
Cytoplasm is moderate basophilic
N:C ratio 4:1
Bone Marrow - if found in peripheral - send for path review
Promyelocyte
Unable to differentiate between different granulocytes
Nucleus is round to oval
1-3 Nucleoli
Chromatin is fine, but slightly coarser than myeloblast
Cytoplasm is basophilic
Granules are primary only
N:C ratio is 3:1
Bone Marrow - if found in peripheral - send for path review
Neutrophilic Myelocyte
Nucleus is round to oval, slightly eccentric, and may have one flattened side
Golgi apparatus may be visible
Chromatin is coarse or more condensed than promyelocy
Granules are mixture of primary and secondary
N:C ratio is 2:1
Bone Marrow
Hard to tell cell line - match with cytoplasm or just call myelocyte
Neutrophilic Metamyelocyte
Nucleus is indented (kidney bean shape) and is less than 50% of the width of hypothetical round nucleus
Chromatin is moderately clumped
Cytoplasm is pale pink to colorless
Granules are mostly secondary with a few primary
N:C ratio is 1.5:1
Bone Marrow
Neutrophilic Band
Nucleus constricted by no threadlike filament, indentation is more than 50% of round nucleus
Chromatin is coarse and clumped
Cytoplasm is pale pink to colorless
Granules mostly secondary with very few primary
N:C ratio - Cytoplasm predominates
Bone Marrow with a few in Peripheral
Segmented Neutrophil
Nucleus is 2 to 5 lobes connected by thin filaments
Chromatin is coarse and clumped
Cytoplasm is pale pink to colorless
Granules are secondary only
N:C ratio - Cytoplasm predominates
Peripheral 40-80%
Eosinophil Myelocyte
Nucleus is round to oval, may have flattened side
Chromatin is coarse and more condensed
Cytoplasm is colorless to pink
Granules is mixture of primary and secondary
N:C ratio is 2:1 or 1:1
Bone Marrow
Eosinophil Metamyelocyte
Nucleus is indented (kindey bean shaped) which is less than 50% of round nucleus
Chromatin is coarse and clumped
Cytoplasm is colorless to cream colored
Granules are mostly secondary with a few primary
N:C ratio is 1.5:1
Bone Marrow
Eosinophil Band
Nucleus is constricted but no threadlike filament, indentation is more than 50% of round nucleus
Chromatin is coarse and clumped
Cytoplasm is colorless to cream colored
Granules are mostly secondary
N:C ratio - Cytoplasm predominates
Bone Marrow
Eosinophil
Nucleus has 2-3 lobes connected by thin filaments without visible chromatin
Chromatin is coarse and clumped
Cytoplasm is cream colored
Granules are secondary only (pale pink to orange)
N:C ratio - Cytoplasm predominates
Peripheral 0-5%
Basophil maturation stages
Maturation parallels that of the neutrophil
Immature stages are very rare outside of Bone Marrow
Peripheral blood only has these stages in basophil proliferative disorders
Basophil
Nucleus normally has 2 lobes connected by thin filaments
Chromatin is coarse and clumped
Cytoplasm is lavender to colorless
Granules are secondary and very large which may obscure nucleus
Granules are H2O soluble and may be washed out
N:C ratio - Cytoplasm predominates
Peripheral 0-1%
Monoblast
Nucleus is round to oval, may be irregularly shaped
1-2 Nucleoli
Chromatin is fine
Cytoplasm is light blue to grey
Granules - none
N:C ratio 4:1
Bone Marrow - if found in peripheral - send for path review
Promonocyte
Nucleus is irregularly shaped, folded (may have brain look)
Chromatin is fine to lacy
Cytoplasm is light blue to grey
Granules are fine azurophilic
N:C ratio 2:1 to 3:1
Bone Marrow
Monocyte
Nucleus is variable, may be round, horseshoe, kidney, or brain look
Chromatin is lacy
Cytoplasm is blue-grey and may have pseudopods
Granules are very fine
Vacuoles are absent to numerous
N:C ratio is variable
Peripheral 2-10%
Macrophage
Nucleus is eccentric, kidney or egg shaped, indented, or elongated
1-2 Nucleoli
Chromatin is fine and dispersed
Cytoplasm is abundant, irregular shaped, and may contain ingested material
Granules are coarse and azurophilic
Vacuoles may be present
Found in tissues such as bone marrow, spleen, liver, lungs, and others. Seen in peripheral during severe sepsis
White Blood Cell Progression - Lymphocytes
1) HSC (stem cell)
2) Common lympoid progenitor
3) Pre-B and Pre-T
4) B lymphoblast and T lymphoblast
5) B prolymphocyte and T prolymphocyte
6) B lymphocyte and T lymphocyte - Peripheral
7) Plasma (B-cell) and T lymphocyte - Tissue
Lymphoblast
Nucleus is round to oval
>1 Nucleoli
Chromatin is fine and evenly stained
Cytoplasm is scant, slightly to moderately basophilic
N:C ratio 7:1 to 4:1
Bone Marrow - if found in peripheral - send for path review
Prolymphocyte
Nucleus is round or indented
0-1 Nucleoli
Chromatin is slightly clumped, intermediate
Cytoplasm is light blue
N:C ratio 3:1 to 4:1
Bone Marrow or Peripheral
Lymphocyte
Nucleus is round to oval, may be slightly indented
Chromatin is condensed, clumped, blocky, and smudged
Cytoplasm is scant go moderate, sky blue, vacuoles may be present
N:C ratio is 5:1 to 2:1
Bone Marrow and Peripheral (25-35%)
Large Granular Lymphocyte
Larger than normal lymphocyte
Reactive looking
Granules may be present
Typically T cells or NK cells - only way to tell would be cytometry
Plasma Cell
Nucleus is round or oval and eccentric
Chromatin is coarse
Cytoplasm is deeply basophilic, often with perinuclear clear zone
N:C ratio is 2:1 or 1:1
Bone Marrow or Tissue - Typically from B cell line
