Bo. D, S.

ABNORMAL WBC 3MT01

Lymphocyte (Lymphocytosis)

Pathologic:

o
o
o
o
o
o

Acute viral and non-viral

infections
Infectious mononucleosis
Mumps
Chicken pox
German measles
Lymphocytic leukemia
Infectious hepatitis
Secondary stage of syphilis
Congenital syphilis
Pertussis
Brucellosis

ABNORMAL WHITE BLOOD CELLS

-

Genetic disorder: non-malignant

o Morphology- Nucleus and
Cytoplasm
o Function- Ex: Motility
(Lazy Leukocytic
Syndrome)

Vacuolated cell
-

Caused by leukemia (dse)

Caused by smearing forcefully
(artifactual)
Large no. maybe seen in this
dse (their presence indicates
increased cell fragility.
o SMUDGE CELL
nuclear remnant of
lymphocyte
appearance is
similar to a
THUMBPRINT.
o BASKET CELL
Nuclear remnant of
granulocytic cells
with NETLIKECHROMATIN
PATTERN.

Hypersegmented neutrophils
1

With vacuoles or holes in

cytoplasm (signs of
degeneration)
May be found in normal blood
smear if the smears is made
from oxalated blood which is
over 2hours old.
o Citric EDTA Oxalate (over
2 hours? Vacuolated)
Seen in smears made from fresh
blood, they should be counted
and reported.
Caused by severe infection
chemical poisoning and
leukemia.

Tart cell (from patient Tart)

-

Smudge cell ( Basket cell)

A.k.a macropolycyte / PA poly

cells
>5-10 lobes
Found in Megaloblastic anemia
(pernicious anemia)

A phagocytic WBCs (usually a

monocyte) with engulfed
nucleus of another cell
Senn in DRUG SENSITIVITY

LE cell ( lupus erythematosus cell)

-

Phagocytic WBC (usually a

neutrophil) that has ingested an
altered homogenous globular
nuclear mass of a destroyed
cell.
Ingested nuclear materials is
more redder than the usual
color of unaltered chromatin.
Found in 80% of causes with
disseminated LE.
Kidney failure
Female commonly affected.
(SLE)

Reider cells
-

Lymphocyte with notched,

LOBULATED (normal is
mononucleosis) or segmented

Bo. D, S. ABNORMAL WBC 3MT01

or CLOVER-LEAF like nucleus in
chronic lymphocytic or
lymphatic leukemia.

Hairy cells
-

hairy cell leukemia

Seen 80% of px with cancer.
Characteristics is fine, hairlike,
irregular cytplasmic granules.

PHA (Pelger-Huet Anomaly)

-

Nucleus failure to segment.

May be CONGENITAL (true PHA)80% exhibit PHA) or ACQUIRED
(pseudo PHA) 50% only and
associated with malignant
myeloproliferative neoplasm
(BLAST)
Pince-Nez form neutrophil
nucleus (eyeglasses
appearance)

A.k.a Dohle-Amato Bodies

- found in NETUROPHILS as
irregular, round to oval, blue
staining cytoplasmic granules
inclusions (size of cocci; 2um in
dm)
Consists of ribosomalRNA in the
periphery cells.
Inclusions may also be found
w/n ban neutrophils.
(+) Periodic Acid Shiff Test
Non specific found in Scarlet
fever (by S.pyogenes)
Appearance of these inclusions
is TRANSIENT only.
May reflects sudden storage
pool release.
Dohle-body like inclusion may
be seen in May-Hegglin
Anomaly.

Toxic Granulation
2

Pseudo TG
Caused by dark
granules due to
over staining.

Alder-Reilly Anomaly
-

Dohle bodies
-

Believed to be altered primary

granules.
o True TG
cluster w/n the
cytoplasm
not all neutrophils
will be equally
affected.

Characteristics: dense
azurophilic granulation in all
type of leukocytes.
Granules are larger than toxic
granules tend to cover the
nucleus.
Granulation results from an
abnormal deposition and
storage of
MUCOPOLYSACCHARIDES.
o Alder bodies
Associated with
SKELETAL
DYSTROPHY.
o Reilly bodies
Associated with
Gragoylism.
Cytoplasmic granulation is NOT
TRANSIENT or related to an
infection, as it is with toxic
granulation.
Alder-Reilly bodies generally are
distributed throughout the cells
and all cells tend to be affected
equally.

Czediak-Higashi Syndrome/
Chediak-Steinbrinck-Higashi
Syndrome
-

Genetic disorder characterized

by GIANT CYTOPLASMIC

Bo. D, S. ABNORMAL WBC 3MT01

GRANULES in the phagocytes

and lymphocytes.
This syndrome affects these
spp:
o Man
o Mink
o Cattle
o Mine
o Cats
o Killer whales
Inherited autosomal recessive
traits.
In SEVERE FORM, all WBC may
be affected and contain giant
lysosomes of varying size up to
4um.
Base defect in the Golgi
Complex
o Responsible for granules
assembly.
Granules are believed to be
normal in the content but
abnormally packaged.
They stain variably as gray,
blue, purple, or orange and (+)
strongly peroxidase.
Affected individual displaces
o Partial albinismmelanosomes in
melanocytes are affected
Have hemorrhagic tendencies
(platelets problems become
granulytic)
Susceptible to a variety of
common infection agents
(leukocyte granules)

Jordan anomaly
-

Rare, autosomal dominant,

qualitive leukocyte abnormality.
Granulocytes of px who have
this disorder demonstrate PALE
BLUE,SPINDLE-SHAPED
INCLUSIONS, Larger (2-5um)
and more prominent than Dohle
bodies found in the periphery
during infection)

Genetic qualitive disorder with

abundant SUDANOPHILIC
inclusions (i.e. Lipids)
Presence of multiple, large
canuoles in all granulocytes and
monocytes which stain positive
for FAT.
1st described in association with
progressive muscular dystrophy
and subsequently ichthyosis
(skin is dry and scaly like fish)
Vacuoles are absent.

Auer bodies / Auer Rods

-

Seen in Acute Myeloid Leukemia

Rod-like bodies which stain
reddish purple in the
cytoplasmic of MYELOBLASTS in
acute myeloid leukemia.
Linear projection of primary,
azurophilic granules.

Lazy Leukocytic Syndrome (about

the function)
-

May-Hegglin Anomaly (affected:

Neutrophil)
-

LARGE,HYPOGRANUMLAR
PLATELETS seen.

Rare condition in which both

random and directed movement
of the cells are defective.
Bone marrow reserves of
granulocytes are normal but
release of cells from the marrow
to the peripheral blood is poor.

Russel bodies
-

Results from the proteinacious

material produced by immune
globulins
These bodies appear as GRAPLIKE STRUCTURE
Sometimes the red stain is
diffused and therefore these
plasma cells are therefore called

Bo. D, S. ABNORMAL WBC 3MT01

FLAME CELLS or FLAMING
PLASMOCYTES.

Neimann pick
-

Dutcher bodies
-

Bodies with glycoproteins

component found in
DYSPROTEINEMIAS.

Gaucher bodies
-

Cytoplasm that has a wrinkled

or onion skin like appearance
Accumulation of
GLUCOCEROBROSIDE
Deficiency in glucocerobroside
or glucosidase.

Bone marrow macrophages with

foamy cytoplasm because of
lipids filled lysozomes.
Or soap-suds appearance
Deficiency in ASM (Acid
Sphingomyelinase)
Deficiency in NPC1 and NPC2
gene (transport of LDL)

Tay Sach (vacuolated cytoplasm)

-

Accumulation of gangloside and

glycolipids.
Deficiency in Hexosaminidase
type A.