5. Macroglossia
Multiple myeloma has been complicated by
primary AL amyloid & macroglossia.
Macroglossia is a resting tongue that
protrudes beyond the teeth.
15. Sideroblastic anaemia
• The bone marrow shows ring sideroblasts
with abnormal deposits of iron in
perinuclear mitochondria which form a
blue-green collar around the nucleus when
stained with Perl’s stain.
41. Hereditary spherocytosis
• Numerous spherocytes (HS) with some
polychromatic cells (AIHA).
• DD hereditary spherocytosis with negative
Coomb’s test or AIHA with +ve DCT.
• Circular spherocytes with no central pallor.
42.
43. Iron deficiency anaemia
• Pencil cells.
• Elliptocytosis.
• Microcytosis (RBC are smaller than the
central lymphocyte).
44.
45. CML
• Many neutrophils and myeloid precursors.
• (Promyelocytes, metamyelocytes,
myelocytes and occasional blast).
• Blast is a large cell with little cytoplasm.
• Three eosinophils are seen with pink
granules in the cytoplasm.
• One basophil is seen with purple cytoplasm.
49. Myelofibrosis
• Anisocytosis & poikilocytosis.
• Tear-drop poikilocytes.
• Leucoerythroblastic blood film: nucleated
RBC in the bottom right-hand corner and a
myelocyte in the top right-hand corner.
50.
51. Acute myeloid leukaemia d.t.
malaria falciparum
• The bone marrow shows falciparum ring
forms with double dots within the red cells
to the right of the centre and in the bottom
right-hand corner.
52.
53. Acute myeloid leukaemia
• The bone marrow shows leukaemic blasts in
a circle with one myelocyte at 1 o”clock.
54.
55. Sickle cell disease
• Target cells, boat-shaped cells pointed at
both ends.
• In the centre there is a red cell containing a
malaria ring form d.t. plasmodium
falciparum.
56.
57. CML in blast crisis or AML.
• The bone marrow is packed with a
monomorphic population of large cells with
minimal cytoplasm, some of which show
vacuoles within the cytoplasm.
58.
59. MAHA
• Red cell fragments, most notably the
fragment right in the centre of the field.
60.
61. B12 deficiency
• Macrocytosis (compare the RBC with the
lymphocyte in the top of the field).
• Many ovalocytes.
• The neutrophil has hypersegmented nucleus
> 5 nuclear lobes.
62.
63. Immune haemolytic anaemia
• Polychromasia, spherocytes.
• Macrocytosis, reticulocytosis.
• Nucleated RBC (top right-hand corner).
• The neutrophils show toxic granulation
secondary to pneumonia (treated with
penicillin which induced immune
haemolytic anaemia).
64.
65. Chronic lymphocytic leukaemia
• Polychromasia, spherocytosis &
lymphocytosis (small lymphocytes).
• The lymphocytes have a round nucleus and
virtually no cytoplasm and appear
monomorphic.
74. Sickle cell disease
• Howell-Jolly bodies are also present,
indicating hyposplenism.
75.
76. Lead poisoning
• Basophilic (blue) stippling of red cells
which is typical of lead poisoning.
• This occurs due accumulation of RNA in
RBCs due inhibition of Pyrimidine 5
Nucleotidase by lead.
84. Hyposplenism
• Variation in erythrocyte size (anisocytosis),
shape (poikilocytosis).
• Howell-Jolly bodies are also seen, which
are intracellular inclusion bodies consisting
of remnants of DNA.
