bone marrow pk
TRANSCRIPT
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Peripheral Blood
The formed elements of peripheral blood include red
blood cells (RBCs), white blood cells (WBCs) and
platelets.
Except for a small percentage of slightly immatureRBCs, i.e., reticulocytes, the RBCs are
homogeneous.
WBCs include a) nongranular leukocytes, i.e.,lymphocytes and monocytes, and b) granular
leukocytes, i.e., neutrophils, eosinophils and
basophils.
Platelets are small, non-nucleated cell fragments.
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Slide 83
Image 1
The most numerous cell is the RBC. Its biconcave shape renders its center thinner (in thin smears)
than the edges so the hemoglobin filling the cell stains more deeply at the perimeter.
The small lymphocyteis a small, round, blue-staining cell. Its heterochromatic nucleus is round,
dark staining, and nearly fills the cell, leaving only a thin rim of light blue cytoplasm in which an
occasional small blue lysosome may be noted. Small lymphocytes are about 6 - 9 microns in
diameter or about the same size as RBCs. Medium lymphocytes can be 2X as large with more
cytoplasm and a less dense nucleus.
The neutrophilic granulocyte is the largest cell in the field - twice the size of RBCs. Its nucleus is
lobated and dark staining. Its cytoplasm is filled with small salmon-colored inconspicuousgranules, which are frequently hard to recognize in the pink cytoplasm.
RBCs , 7-8
Sm. Lymphocyte, 6-9
Neutrophil, 15 Lymphocyte
RBC
Neutrophil
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Slide 83 Image 2
The basophils lobated nucleus is often hidden by the coarse blue-purple
granules of its cytoplasm. Neutrophilic granules are poor-staining and often
hard to distinguish in neutrophils. The nucleus of the neutrophil may have 3
- 5 lobes. The eosinophil has coarse red granules; its nucleus often has 2 or
3 lobes.
Basophil, 15(with neutrophil)
Neutrophil, 15Eosinophil, 15
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Slide83Image 3
Monocytes are about twice the size of the small lymphocyte or
RBC. Its nucleus is not very heterochromatic, but is often
indented or folded. Its abundant cytoplasm stains gray-blue
and may contain occasional lysosomes. Lymphocytes have a
more heterochromatic nucleus and a sky-blue cytoplasm.
Monocyte, 15Lymphocytes
Small
Medium
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Monocyte
Slide 83 Image 4
Summary slide.
Granular leukocytes: neutrophil, eosinophil, basophil.
Non-granular leukocytes: lymphocytes, monocyte.
Eosinophil
Lymphocytes
NeutrophilNeutrophil
Basophil
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Demo Slide
Image 5
Bone marrow , r ib, paraf f in sect ion -low mags.Actively hemopoietic (red) marrow is filled with developing RBCs, WBCs,platelets, and lymphocytes. Reticular ct supports the developing cells.Large, light staining fat cells vary in number. Colonies of dark staining cellsare developing RBCs, usually situated at the edge of blood-filled sinuses.Megakaryocytes are large pink cells also obvious near the sinuses. The
remaining cells are mostly developing granulocytes.
Fat cell
Sinus
RBCs
Granulocytes
Megakaryo.
Periosteum
Outer cortical bone
Marrow cavity
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The study of bone marrow from smears
Bone marrow is usually removed by suction from the
iliac crest. A small fragment of the semi-solid marrow
is placed between two glass coverslips, which gently
compresses it. Coverslips are then pulled across eachother spreading the cells of the marrow into a thin
film. The marrow smear is then stained with a blood
stain such as Wrights or Giemsa. These stains are
good for distinguishing the subtleties of thedeveloping granules, cytoplasm and nuclei. Unlike the
usual histologic stains, which cause nucleoli to appear
dark, blood stains leave nucleoli pale.
B M S
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Bone Marrow Smear
Bone Marrow smear at low mag. Whole cells are spread thinly to revealcellular details for further identification under oil immersion magnification.
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CFU-GM
Promyelocyte
Myeloblast
CFU-GCFU-M
Myelocytes
CFU-E
Proerythroblast
Monocyte
Monoblast
Megakaryoblast
Megakaryocyte
Platelets
Lymphoblasts
(T & B)
CFU-L
Pluripotential Stem Cell
Lymphocyte
& Plasma cell
Polychrome
Basophilic
Erythroblast
Metamyelocytes
CFU-Meg
Orthochrome
Mature granulocytesRBC
CFU-GEMM
CFU-Eo CFU-Bas
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RBC & Granulocyte DevelopmentMyeloblast Promyelocyte Myelocyte Metamyelocyte Juvenile Mature
Proerythroblast Baso-erythroblast Polychrome- Orthochrome RBC
Pluripotential
Stem Cell
rare
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Bone marrow , paraf f in sect ion -low mag.Megakaryocytes are large pink cells also obvious near the
sinuses. The remaining cells are mostly developinggranulocytes.
Megakaryocyte
Megakayocytes
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Megakayocyte
Mature
The megakaryocytebegins its development from a megakaryoblast which
closely resembles all other blast cells. Early in development it undergoes
mitotic divisions to increase its numbers but finally it undergoes only
endomitotic divisions. This results in no additional cells but the cell increases
dramatically in size and nuclear complexity. The cytoplasm is abundant and
finley granular; the nucleus remains single but it is highly lobulated.
Megakayocyte, ~ 200
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Slide 83 Image 5/5
Platelet
Platelet
Platelets are cell fragments whose size varies between 2 - 4microns (compare to RBC, 7 , neutrophil 15 ) . They have no
nuclei, their cytoplasm stains light blue and is slightly granular.