Wbc

R
raj kumar
••
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
WBC/LYMPHOID DISORDERS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
NEUTROPHILS ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
NEUTROPHIL Neutrophil Polymorphonuclear Leukocyte, PMN, PML “ Leukocyte” Granulocyte, Neutrophilic granulocyte “ Poly-” Polymorph www.freelivedoctor.com
NEUTROPHIL MATURATION www.freelivedoctor.com
LYSOSOMAL CONSTITUENTS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
FUNCTIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
PELGER-HUET ANOMALY ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
CHEDIAK-HIGASHI SYNDROME ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
LEUKO-penia/NEUTRO-penia Neutropenia/Agranulocytosis ,[object Object],[object Object],[object Object],www.freelivedoctor.com
INADEQUATE PRODUCTION ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
INCREASED DESTRUCTION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Leukocytosis/Neutrophilia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
NEUTROPHIL INCREASES (e.g., “NEUTROPHILIA”) ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
EOSINOPHIL INCREASES (i.e., “EOSINOPHILIA”) ,[object Object],[object Object],www.freelivedoctor.com
BASOPHIL INCREASES (i.e., “BASOPHILIA”) ,[object Object],[object Object],www.freelivedoctor.com
MONOCYTE INCREASES (i.e., “MONOCYTOSIS”) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
LYMPHOCYTE INCREASES (i.e., “LYMPHOCYTOSIS”) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
LYMPHOCYTE INCREASES (i.e., “LYMPHOCYTOSIS”) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
“ MYELOPROLIFERATIVE” disorders ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
CML ,[object Object],[object Object],[object Object],www.freelivedoctor.com
CML ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
www.freelivedoctor.com
www.freelivedoctor.com
Polycythemia Vera ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
ESSENTIAL THROMOCYTOSIS ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
PRIMARY MYELOFIBROSIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
www.freelivedoctor.com
WBC/LYMPHOID DISORDERS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
LEUKEMIAS ,[object Object],[object Object],[object Object],www.freelivedoctor.com
Leukemias vs. Lymphomas ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
LYMPHOMAS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
LEUKEMIAS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
BLAST www.freelivedoctor.com
WHITE CELL NEOPLASMS Leuk/Lymph ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
WHITE CELL NEOPLASMS Leuk/Lymph ,[object Object],[object Object],[object Object],www.freelivedoctor.com
A.L.L./LYMPHOMAS* ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
A.L.L./LYMPHOMAS ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
A.L.L. www.freelivedoctor.com
C.L.L. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
C.L.L. www.freelivedoctor.com
C.L.L. ,[object Object],[object Object],[object Object],www.freelivedoctor.com
MULTIPLE MYELOMA ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
PLASMA CELL classic features ,[object Object],[object Object],[object Object],www.freelivedoctor.com
MONOCLONAL “SPIKE” on SPE www.freelivedoctor.com
MULTIPLE MYELOMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
Multiple Myeloma: Skull X-ray www.freelivedoctor.com
“ Solitary” Plasmacytoma ,[object Object],www.freelivedoctor.com
M.G.U.S. ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
Other “GAMMOPATHIES” ,[object Object],[object Object],[object Object],www.freelivedoctor.com
A.M.L. ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
A.M.L. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
M0  M2 www.freelivedoctor.com
M3 www.freelivedoctor.com
M4-M5 AMML Normal “classic” monocyte www.freelivedoctor.com
M6-M7 www.freelivedoctor.com
A.M.L. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
MYELO-DYSPLASTIC SYNDROMES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
Ring Sideroblasts and “BUDS” www.freelivedoctor.com
LYMPH NODES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
www.freelivedoctor.com
CORTEX ---SUB-capsular Sinus ---Follicles (Pri? Or second.?) ---PARA-follicular zone MEDULLA Blood flow? Lymph flow? www.freelivedoctor.com
Definition of TERMS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
BENIGN ENLARGEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
www.freelivedoctor.com
www.freelivedoctor.com
(MALIGNANT) LYMPHOMAS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
DIFFUSE LYMPHOMA www.freelivedoctor.com
FOLLICULAR LYMPHOMA www.freelivedoctor.com
LARGE CELL LYMPHOMA www.freelivedoctor.com
SMALL CELL LYMPHOMA www.freelivedoctor.com
“ CLEAVED” CELL LYMPHOMA www.freelivedoctor.com
“ Hairy” Lymphocyte www.freelivedoctor.com
FEATURES of LYMPHOMAS ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
LATEST CLASSIFICATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
PRECURSOR B ,[object Object],www.freelivedoctor.com
PERIPHERAL B ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
PRECURSOR T ,[object Object],www.freelivedoctor.com
PERIPHERAL T and NK ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
LYMPHOCYTE MARKERS (CD-) i.e., LYMPHOCYTE ANTIGENS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
HODGKINS DISEASE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
STERNBERG-REED CELL www.freelivedoctor.com
STAGING, HD & NHD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
METASTATIC CARCINOMA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
METASTATIC SQUAMOUS CELL CARCINOMA www.freelivedoctor.com
METASTATIC ADENOCARCINOMA www.freelivedoctor.com
SUBCAPSULAR SINUS www.freelivedoctor.com
SPLEEN ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
www.freelivedoctor.com
ABNORMAL SPLEEN www.freelivedoctor.com
ABNORMAL SPLEEN www.freelivedoctor.com
SPLENIC FUNCTION ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
SPLENOMEGALY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
SPLENOMEGALY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],LONG STANDING CONGESTION breeds FIBROSIS www.freelivedoctor.com
INFARCT www.freelivedoctor.com
PRIMARY TUMORS (RARE) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
MISC ,[object Object],[object Object],[object Object],www.freelivedoctor.com
THYMUS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
HASSAL’s CORPUSCLES www.freelivedoctor.com
DISEASES ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
THYMOMAS ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com
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Wbc

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Wbc

Editor's Notes

  1. Many names, same cell
  2. ALL blasts look the same on routine stains, whether they are myeloblasts, lymphoblasts, monoblasts, etc.
  3. TOXIC GRANULES are EXAGGERATIONS of the marrow’s normal granularity, DOHLE bodies are fragments of remaining dilated rough ER
  4. Not only are basophils RARE to find normally, but pure “basophilia” is also VERY rare.
  5. Why would monocytosis be linked to granulomatous diseases? Answer: Monocytes are macrophages in circulation, and granulomatous diseaseas are macrophage diseases.
  6. EXTRAMEDULLARY HEMATOPOESIS is most common in the spleen, liver, and lymph nodes.
  7. If a CML had much more than 10% blasts, you might suspect that the patient was going into a “blast crisis”.
  8. This marrow is virtually 100% cellularity!!! This is the HALLMARK of CML, and all the cells are still marrow cells although blasts are INCREASED, i.e., more than 1-2 % This marrow is virtually 100% cellularity!!! This is the HALLMARK of CML, and all the cells are still marrow cells although blasts are INCREASED, i.e., more than 1-2 %
  9. This marrow is virtually 100% cellularity!!! This is the HALLMARK of CML, and all the cells are still marrow cells although blasts are INCREASED, i.e., more than 1-2 %. In this CML megakaryocytes are proliferating so what OTHER myeloproliferative disease could this be confused with? Ans: essential thrombocythemia (essential thrombocytosis)
  10. Note most of the marrow looks “fibrotic”. What stain could help you confirm that this is fibrous tissue? (trichrome)
  11. The most life saving thing you can learn today is how to recognize a blast! HUGE NUCLEUS NUCLEOLI (stain LIGHTER not DARKER than the rest of the nucleus on Wright stain), How many nucleoli does that one blast cell have? Answer: 3 NO cytoplasmic differentiation
  12. Many cells from CLL have a “smudge” or “basket” appearance
  13. Please those THREE diagnostic features of plasma cells, the malignant plasma cells of MM look like normal plasma cells usually.
  14. Normal on left, myeloma on right.
  15. Note the “lytic” lesions
  16. Blasts, blasts with AUER rods
  17. Acute promyelocytic leukemia, remember promyelocytes have BOTH nucleoli AND nonspecific granules, true BLASTS do NOT have granules.
  18. In AMML, M4, many of the peripheral leukemic cells look like monocytes, while in M5, Acute Monocytic Leukemia, MOST of them look like monocytes
  19. In M6, many of the cells may resemble erythroid cells, in M7, many of the cells may resemble megakaryocytes
  20. Know the difference between a myelo-”proliferative” and a myelo-”dysplastic” disease.
  21. BENIGN FOLLICULAR HYPERPLASIA. Larger and more numerous than normal follicles. MEDULLA may be compromised.
  22. BENIGN SINUS HISTIOCYTOSIS. The cortical area may be compromised. SINUS HISTIOCYTOSIS may be seen in reaction to cancer, even if there are NO tumor cells in the lymph node.
  23. “ HAIRY” cell leukemia/lymphoma consists of lymphocytes which look hairy.
  24. Most pathologists HATE lymphoma classifications with a passion!
  25. I HATE this slide.
  26. I HATE this slide even worse.
  27. Prognosis of HD disease is related directly of percentage of lymphocytes and inversely to number of RS cells.
  28. STERNBERG REED cells are called “lacunar” cells in one of the most common forms of HD called NODULAR SCLEROSING
  29. The subcapsular sinus of the lymph node is the FIRST place you will spot a metastatic tumor nest!
  30. Notice the “confluence” of WHITE pulp? Could this be lymphoma involvement? Ans: Yes Could this be granulomas? Ans: YES
  31. Portal hypertension, prominence of RED pulp
  32. Note all these are benign. The commonest MALIGNANT tumor primary to the spleen is a LYMPHOMA
  33. Hassal’s corpuscles are fused epithelial reticular cells