Wbc Abnormalities

8/2/2019 Wbc Abnormalities

1/37

WBC

Abnormalities

Carlo Chris S. Apurillo,RMTInstructor, Clinical Hematology

College of Medical Technology


2/37

Morphologic Abnormalities of

Granulocytes


3/37

1. Alder-Reilly anomaly

Large, coarse, darkmetachromatic granules

Found in geneticmucopolysaccharidoseslack of lysosomalenzymes to break down

mucopolysaccharides


4/37

1. Alder-Reilly anomaly


5/37

2. Auer Rods

Pink/red rod like bodiesfused with granules

Associated with APL (M3) acute promyelocyticleukemia


6/37

2. Auer Rods


7/37

3. Chediak Higashi Granules

Large, round blue graybodies

Chediak Higashi

syndrome rareautosomal recessivecondition associated withabnormally largeleukocyte granulesresulting from fusion oflysozymes


8/37

3. Chediak Higashi Granules


9/37

4. Dohle bodies

small, oval inclusions inthe cytoplasm of PMNsthat stain pale blue with

Wrights stain.

Aggregates of freeribosomes

Associated with severeinfection


10/37

4. Dohle bodies


11/37

4. Dohle bodies


12/37

5. May-Hegglin Anomaly

Rare autosomal dominantcondition characterized bypresence of pale blue

inclusions resemblingDohle bodies inneutrophils

Larger and moreprominent than Dohlebodies

Characterized by giant plts


13/37

5. May-Hegglin Anomaly


14/37

6. Hypersegmented neutrophil

Neutrophil with more than5 segments

Due to abnormal DNAsynthesis

Found in: megaloblasticanemia

Shift to the right


15/37

6. Hypersegmented neutrophil


16/37

7. LE Cell

Large, round, purplehomogenous inclusionsurrounded by flattened

nuclei.

Found in Systemic lupuserythematosus


17/37

7. LE Cell


18/37

8. Pelger Huet Anomaly

Single or bilobed nucleus(hyposegmentation)

Hereditary, autosomaldominant condition whichinvolves failure of normalsegmentation of

granulocytic nuclei


19/37

8. Pelger Huet Anomaly


20/37

9. Toxic granulation

Large dark blue to purplecytoplasmic granules inthe metamyelocyte, and,

or neutrohil stage. Primary granule

enhancement

Found in severeinfections, toxic states,burns, malignancy andchemical poisoning


21/37

9. Toxic granulation


22/37

9. Toxic vacuoles

Large, empty white areas

End stage phagocytosis

Found in: septicemia,severe infections, toxicstates.


23/37

Morphologic Abnormalities of

Lymphocytes


24/37

1. Basket Cell/Smudge cell

Degenerated nucleus,ruptured cell due to itsfragility

Found in: chroniclymphocytic leukemia

Artifact if few


25/37

1. Basket Cell/Smudge cell


26/37

2. Flame cell

Plasma cell with pink tored cytoplasm

Increase IgA (multiplemyeloma)


27/37

3. Grape Cell/Mott Cell

Also known as Russelbodies

Vacuolated plasma cell

Found in multiplemyeloma; reactive states


28/37

3. Grape Cell/Mott Cell


29/37

4. Reactive Lymphocytes

Also known as Atypicallymphocytes or DowneyCell

Type I Vacuolated

Type II Stresslymphocyte

Type III Lymphoblastlike


30/37

4. Reactive Lymphocytes

>20% - infectiousmononucleosis, viralHepa


31/37

Review!

Alder-Reilly granulesChediak Higashigranules

Auer Rods


32/37

Review!

May-Hegglinanomaly

Dohle bodieshypersegmentation


33/37

Review!

LE Cell

Pelger Huet


34/37

Review!

Toxic granulationBasket cell


35/37

Review!

Flame cell

Grape cell


36/37

Review!

Atypical lymphocytes


37/37

The end

Wbc Abnormalities

Documents