Abnormal morphology of white blood cell white blood cells may exhibit several morphological changes, and the neutrophils are the cell type primarily affected. The morphology and clinical relevance of red cells, white cells, and platelets, and their respective precursors, both normal and. White blood cells wbc are a heterogeneous group of nucleated cells that can be found in circulation for at least a period of their life. American proficiency institute 2009 3rd test event educational commentary morphologic features of normal and abnormal lymphocytes cont. Most of these neutrophilic changes originate in the cytoplasm in response to various pathologic processes. This test is included in general health examinations and to help investigate a variety of illnesses. Abnormal red cell morphology cell type showing bilobed nucleus. White blood cell morphologic features are less speciesdependent than red blood cells, although there are some species peculiarities e. Some of these may be due to a primary blood disorder such as sickle cell anemia. White blood cell disorders can affect your bodys immune response and your bodys ability to fight. The differential wbc count and blood cell study may be performed by one of several methods, e. Normal mature rbc are biconcave, round discs that are about 6 8 in diameter, which is only slightly smaller than the normal small mature lymphocytes about 6 10 in diameter. The same basic principles are followed for identifying leukocytes in different animal species, with the exception of exotics and. Place a clean glass spreader slide in front of the drop of blood at an approximate 30 angle to the bloodfilm slide.
Evaluation of cell morphology and introduction to platelet and white. The number of white blood cells in a given volume of blood is expressed as cells per microliter of blood. Utmost attention to the analysis of hematological changes is es sential for a timely. Summary of abnormal red blood cell morphologies and. The total white blood cell count normally ranges between 4,000 and 11,000 cells per microliter 4 to 11. Reporting and grading of abnormal red blood cell morphology. Identify the types of white blood cells in a normal differential count. Summary of abnormal red blood cell morphologies and disease. Morphological abnormalities of red blood cells the art of. The purpose of the book is to provide a practical approach that will make the evaluation of cell morphology in the manual differential white blood cell count and peripheral blood smear more. This is a video describing various morphological abnormalities found in red blood cells, including changes in red cell size, shape, color, and distribution.
The feather edgeor tailof the slide, should be scanned at low power to assess white cells any large abnormal cells or platelet clumps principle white blood cells. The main disadvantage of the smear is a nonuniform distribution of red blood cells over the smear, with small crowded red blood cells at the thick edge and large. A study of white blood cell morphology and distribution of blood cells is an essential part of the clinical description of practically every disease. Grading guide is a reference guide for grading red blood cell abnormalities, white blood cell abnormalities, and platelet morphology. The white blood cell and differential count clinical. Nucleated erythrocytes are not identified according to stage of maturation, but the total number present on a differential cell count should be reported. These abnormal blood cells, or cancerous cells, prevent your blood from performing many of its functions, like fighting off infections or preventing serious bleeding. The size of the red blood cells is smaller than the white blood cells.
Summary of abnormal red blood cell morphologies and disease states. Leukemia, a type of cancer found in your blood and bone marrow, is caused by the rapid production of abnormal white blood cells. They are abnormal and have a convoluted, twisted nucleus sometimes resembling a clover. However, variable abnormal erythrocyte morphology is found in various pathological conditions. Abnormal appearing white cells are evaluated under oilimmersion objective. Artifacts, artifactual changes in blood cells, contaminants, and miscellaneous findings, along with an approach to blood smear examination, are covered in the 1st section. Identify normal red blood cell morphology on a peripheral smear. Morphological abnormalities of blood and bone marrow leukocytes. Blood cell morphology tutorial lsu school of medicine. White blood cell morphology stellenbosch university. These abnormal blasts begin to take over the bone marrow and prevent production of adequate numbers of other types of blood cells, such as platelets, red blood cells and healthy white blood cells.
How to interpret and pursue an abnormal complete blood cell. A white blood cell differential is a medical laboratory test that provides information about the types and amounts of white blood cells in a persons blood. Red blood cells erythrocytes are biconcave disks with a diameter of 78 microns, which is similar to the size of the nucleus of a resting lymphocyte. Neutrophils neutrophilic granules give the cytoplasm a lilac or pinkish appearance csw lsuhsc 2002 note. The are numerous abnormalities that can occur in different types of illness. Leukocytes, or white cells, are responsible for the defense of the organism. Normally, people produce about 100 billion white blood cells a day. Oct 16, 2015 this is a video describing various morphological abnormalities found in red blood cells, including changes in red cell size, shape, color, and distribution. The blood smears were stained using the giemsa, wright and new methylene blue methods. What could be causing abnormal white blood cell count. Jan 16, 2015 white blood cell and red blood cell morphology. The cells are red cells or erythrocytes, white cells or leucocytes and platelets.
Polymorphic neutrophils pmns polymorphic neutrophils pmns are the most common subtype of white blood cells. Morphological abnormalities of red blood cells the art. Wbc can also be identified and classified as to csw lsuhsc. An automated multichannel instrument in this exercise, it is a coulter stks 5part differential, which is discussed in the auto mated cbc section. In wellspread, dried and stained films the great majority of cells have round, smooth contours and diameters within the comparatively narrow range of 6. The density of the leukocytes in the blood is 50007000mm 3. Before we start with the abnormal morphologies, lets talk about normal morphology of red blood cells. Abnormal white blood cell count can have various causes, ranging in severity from needs attention to critical. List the terms referring to abnormal red cell distribution, variation in red cell size. Rbc morphology is the appearance of the red cells under the microscope. To defend the body adequately, a sufficient number of white blood cells must receive a message that an infectious organism or foreign substance has invaded the body, get to where they are needed, and then kill and digest the harmful organism or.
The nucleus is round or slightly clefted with coarsely clumped chromatin. Check for even distribution and estimate the number present also, look for any gross abnormalities present on the smear. Clearly we can all appreciate the normal shape of a red blood cell. Others may be due abnormalities such as iron deficiency. These cells have a high nuclearcytoplasmic ratio with a thin rim of deep blue cytoplasm. Morphologic features of normal and abnormal lymphocytes. In fact, production of leukemic blasts may get so out of hand, that the immature cells spill out from the bone marrow into the circulation. Segmentation of white blood cells and comparison of cell. Place a small drop of fresh, wellmixed anticoagulated blood on a clean glass slide approximately 2 cm from one end of the slide. White blood cells identi cation and classi cation from. Small azurophil rods in the cytoplasm of myeloblasts and promyelocytes. Standardization of white cell morphology reporting duration.
Learning objective main objective of presentation is to know different type of normal white blood cell and abnormal cell and cases where this type os cell can be present 2 nazar ahmed mohamed abdalla sangoor2007 3. The test, which is usually ordered as part of a complete blood count cbc, measures the amounts of the five normal white blood cell types neutrophils, lymphocytes, monocytes, eosinophils and basophils as well as abnormal cell. Symptoms of anemia like fatigue occur because organs arent getting. In the blood, they are much less numerous than red cells. Blood cell morphology in health and disease clinical gate. The total white blood cell count can be abnormally high or low usually as a result of a change in one or more of its component subtypes.
Image bci15 depicts an echinocyte, also called a crenated or. Sezary disease or syndrome consists of abnormal t cells that result in cutaneous lymphomas of the skin and microabscesses, erythroderma and hepatosplenomegaly, along with sezary cells seen in the peripheral blood smear. The presentation of illustrative cells in this module is by no means a comprehensive study of blood cells. Tutorial blood cell morphology a clinical pathology 201. Blood morphology ask hematologist understand hematology. Grading of abnormal cells, nomenclature and a brief description of the cells are provided. However, an increase in the number of white blood cells is also caused by cancers of the bone marrow such as leukemia with the release of. A blood smear is considered abnormal when theres an abnormality in the size, shape, color, or number of cells in your blood. Red blood cells are the major cellular component of blood.
In this lesson, all normal and most commonly seen abnormal blood cells are morphologically described. These are darkly staining, bluepurple, coarse granules in the cytoplasm of neutrophils. Blood cells can be identified in blood films stained with a mixture of basic and acidic dyes. In health, the red blood cells vary relatively little in size and shape. A white blood cell wbc count determines the concentration of white blood cells in the patients blood. White blood cells leukocytes are an important part of the bodys defense against infectious organisms and foreign substances the immune system. Segmented neutrophils are typically 10 to 12 11min diameter and have single nuclei with several indentations resulting in the. A differential leukocyte count should be carried out.
They play a most important role in phagocytosis and immunity and therefore in defense against infection. If a blood or other diagnostic test indicates a high or abnormal white blood cell count, it can indicate several problems, including. Sezary disease or syndrome consists of abnormal tcells that result in cutaneous lymphomas of the skin and microabscesses, erythroderma and hepatosplenomegaly, along. Jan 28, 2018 morphological abnormality of white blood cell 1. Are white blood cell abnormalities associated with disease. The result indicated that blood cell morphology in quails is similar to that in chickens and other birds.
The test, which is usually ordered as part of a complete blood count cbc, measures the amounts of the five normal white blood cell types neutrophils, lymphocytes, monocytes. The key word for it is biconcave disc, meaning that it is a disc shaped or circular cell that is compressed at the centre in both directions. Introduction more than four decades ago, equipped with the earliest automated hematology coulter counter model s to count blood cells and to determine the size mcv and hypochromia mch of the red cells, an attempt was. Blood, morphology, rbc, platelets, wbc summary these guidelines provide information on how to reliably and consistently report abnormal red blood cells, white blood cells and platelets using manual microscopy. Lesson assignment lesson 4 morphology of blood cells. Finding the true cause means ruling out or confirming each possibility in other words, diagnosis. Red blood cell morphological abnormalities youtube. Red blood cell morphology, grading system, standardization summary in spite of the continual standardization of test result formats, the improvements of laboratory technologies, publications of reference guidelines, and the advancements in hematology analyzers, the methods of reporting or grading abnormal red blood cell morphol. The absolute white blood cell counts are most useful, and are calculated by multiplying. American proficiency institute 2014 2nd test event cell.
The hemoglobin is the essential pigmenting component of red blood cells, which is located at the marginal border of the cells and almost 30 to 45% central area of the diameter is denoted as central pallor. Jun 19, 2017 white blood cells leukocytes help defend the body against infection and foreign substances. Overview of white blood cell disorders blood disorders. In normal red blood cells, there is an area of central pallor that measures approximately the diameter of the cell. An artefact of edta anticoagulation, this may cause the platelet count to be. Although general rules for identification are given along with representative photographs and drawings, it is important to realize that no biological. Morphology of blood cells blood body fluids biology. Infection auto immune haemolytic anaemia incompatible blood transfusion auer rods. Jan 14, 2020 red blood cells are the major cellular component of blood. It is limited to the material covered in the lectures and laboratory sessions. Composition of the blood the circulating blood is composed of plasma and cells. Mature red blood cells are biconcave discs that lack nucleus and most cell organelles such as lysomes, endoplasmic reticulum and mitochondria. A differential determines the percentage of each of the five types of mature white blood cells.
Red blood cells are the most common type of blood cell and are responsible of delivering oxygen to the body tissues. Abnormal white blood cell morphology answers on healthtap. Unfortunately, a few cell illustrations are not available at this time but will be added. Their normal concentration in blood varies between 4000 and 10,000 per microliter.
A normal number and distribution of cells in the blood are so important as physiologic constants that some authorities say the absence of. Normal white blood cell white blood cell is divided into five categories which are. Color atlas of hematology practical microscopic and clinical. On peripheral blood smear, two types of lymphocytes are distinguished. Leukemia is a blood cancer that can be detected through the analysis of wbcs or leukocytes. Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms. Two sets of blood smear images were used in this studys experiments. Blood smears were observed for evaluation of leukocyte morphology. Normal red blood cells are round to very slightly ovoid cells and a central pale area. Normal white blood cell morphology segmented neutrophil segmented neutrophils are the most common white blood cells in peripheral blood of all the common domestic. Abnormal results may vary depending on the type of blood cell. White blood cell inclusions and abnormalities hematology. Any deviation in size, volume, or shape of red cells which represents an abnormal red blood cell. The normal red blood cell to identify abnormal morphology, one must be competent in normal morphology identi.1324 1174 1442 483 1433 467 317 612 531 1236 517 681 920 395 1161 1275 1418 56 259 1074 130 243 756 1435 1301 557 1054 1069 1054 1444 1264 1443 400 737 1468 133