blood cell morphology session1.ppt

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Blood Cell MorphologySession 1

Ashraf ShaqalaihBSc(MT), MSc(MT), CLS(H), CLSp(H)(NCA)Clinical Laboratory Specialist in Hematology

andClinical Immunohematologist Technologist

(Lic#238, State of California, USA)

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وفقط

يرصحو

دية

الرب

مخرات

مندى

وعض ه

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Normal Blood Cells

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How cells can be recognized or

identified microscopically??????

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1- Cell size:

Blood cells can be discriminated on the basis of their

cell size

Orthochromic

normoblast or also

called as NRBC

(nucleated RBC)

Metamyelocyte

Promegakaryocyte

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2- Overall cell size:

The most immature cells are large insize, as the cell become more and

more mature the overall cell sizedecreases.

Immature More mature More and more mature  Mature last stage to PB

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3- Nucleus and its morphological

changes

We look for the following things:

Nucleus to cytoplasm ratio (N/Cratio)

Nuclear shapeNucleolus: size, number

Nuclear chromatin: coarse or fine

Nuclear chromatin arrangementNuclear position

Nuclear lobulation and

number of lobes

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1- N/C Ratio

N/C ratio means the nucleus to cytoplasmratio.

Immature cells have higher N/C ratio thanmature cells

As cell become more mature its nucleus willbe decreased in size and subsequentlycytoplasm increase in amount.

So when you see a cell with high N/C ratioyou become suspicious that it is immaturecell, but this is NOT always true as maturelymphocytes have high N/c ratio.

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The granulocytic maturation series

Myeloblast Promyelocyte Myelocyte Metamyelocyte Band Neutrophil

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Examples: N/C ratio

N/C ratiodecreases as cell

matures

N/C ratio

decreases as cell

matures

N/C ratio

decreases as cell

matures

Myeoblast

Myelocyte

Metamyelocyte Band Neutrophil

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Nucleolus size and their number 

Nucleolus are foundin the mostimmature cells, sothere presence alertus that the cell

between our hand isimmature.

Also their numberand size may also

aid in theidentification ofcells.

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Nuclear position:

Position of

nucleus also may

let us be aware of

specific cell type. Plasma cells

have eccentric

position

nucleus

RBC lineage

Neutrophilic Myelocyte

NeutrophilicMetamyelocyte

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2- Cytoplasm: we look for:

Cytoplasm color

Granulation

Type of granules (primary orsecondary)

Granules cover the nucleus or

not??Cytoplasmic inclusion bodies

Rigidity of the cytoplasm (م ى قو ه

)

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Cytoplasm color 

Most immature cells will have deepblue cytoplasm as the cells maturethe blue color decreases and

decreases and may be changed toorange color or to gray coloraccording to the cell type.

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Granulation

All red blood cell precursors are NON granulated.

The Myeloblasts are nongranulated (but this maydeviate in specific situations).

The granulocyte precursors are granulated frompromyelocyte to the most mature segmentedforms.

Lymphocytes and its precursors arenongranulated (but there are some cells that aregranulated and these cells are mostly naturalkiller cells (NK)).

Most mature megakaryotcytes are granulated.

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Type of granulationGranules are present in the cytoplasm of cells.

Granulation starts from primary granules oralso are celled azurophilic granules, ornonspecific granules.

These granules are dark blue or even willappear as black according to your staining.

The will appear the specific granules or calledsecondary granules ( for example: Eosinophil

will have orange granules, basophil will havedark blue granules, neutrophils will have pinkgranules)

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Granules cover the nucleus!

Some cells the granules cover thenucleus such as the promyelocyte(primary granules), basophil (specific

granules: dark violet in color andbig), mast cells (same as basophilbut the granule are more numerous).

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Rigidity of the cytoplasm (م ى قو ه

)

This is used to differentiate betweenatypical lymphocyte and monocytesand not all times we we talk aboutthis later on……….

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Cell Maturation

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Erythrocyte recognizable

maturation

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