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8/2/2019 Wbc Abnormalities
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WBC
Abnormalities
Carlo Chris S. Apurillo,RMTInstructor, Clinical Hematology
College of Medical Technology
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Morphologic Abnormalities of
Granulocytes
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1. Alder-Reilly anomaly
Large, coarse, darkmetachromatic granules
Found in geneticmucopolysaccharidoseslack of lysosomalenzymes to break down
mucopolysaccharides
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1. Alder-Reilly anomaly
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2. Auer Rods
Pink/red rod like bodiesfused with granules
Associated with APL (M3) acute promyelocyticleukemia
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2. Auer Rods
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3. Chediak Higashi Granules
Large, round blue graybodies
Chediak Higashi
syndrome rareautosomal recessivecondition associated withabnormally largeleukocyte granulesresulting from fusion oflysozymes
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3. Chediak Higashi Granules
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4. Dohle bodies
small, oval inclusions inthe cytoplasm of PMNsthat stain pale blue with
Wrights stain.
Aggregates of freeribosomes
Associated with severeinfection
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4. Dohle bodies
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4. Dohle bodies
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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
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5. May-Hegglin Anomaly
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6. Hypersegmented neutrophil
Neutrophil with more than5 segments
Due to abnormal DNAsynthesis
Found in: megaloblasticanemia
Shift to the right
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6. Hypersegmented neutrophil
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7. LE Cell
Large, round, purplehomogenous inclusionsurrounded by flattened
nuclei.
Found in Systemic lupuserythematosus
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7. LE Cell
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8. Pelger Huet Anomaly
Single or bilobed nucleus(hyposegmentation)
Hereditary, autosomaldominant condition whichinvolves failure of normalsegmentation of
granulocytic nuclei
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8. Pelger Huet Anomaly
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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
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9. Toxic granulation
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9. Toxic vacuoles
Large, empty white areas
End stage phagocytosis
Found in: septicemia,severe infections, toxicstates.
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Morphologic Abnormalities of
Lymphocytes
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1. Basket Cell/Smudge cell
Degenerated nucleus,ruptured cell due to itsfragility
Found in: chroniclymphocytic leukemia
Artifact if few
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1. Basket Cell/Smudge cell
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2. Flame cell
Plasma cell with pink tored cytoplasm
Increase IgA (multiplemyeloma)
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3. Grape Cell/Mott Cell
Also known as Russelbodies
Vacuolated plasma cell
Found in multiplemyeloma; reactive states
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3. Grape Cell/Mott Cell
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4. Reactive Lymphocytes
Also known as Atypicallymphocytes or DowneyCell
Type I Vacuolated
Type II Stresslymphocyte
Type III Lymphoblastlike
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4. Reactive Lymphocytes
>20% - infectiousmononucleosis, viralHepa
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Review!
Alder-Reilly granulesChediak Higashigranules
Auer Rods
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Review!
May-Hegglinanomaly
Dohle bodieshypersegmentation
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Review!
LE Cell
Pelger Huet
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Review!
Toxic granulationBasket cell
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Review!
Flame cell
Grape cell
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Review!
Atypical lymphocytes
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The end