The document provides information about Protege Education Center's career development programs. It offers tutoring and test preparation for high school and college students. It also provides training to become a medical laboratory scientist, including preparation for the ASCP exam, with online options available. The document contains slides about white blood cell morphology and counts, as well as information about hematology. In summary, the document outlines Protege Education Center's career training programs in healthcare fields like medical laboratory science.

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2. Medical Laboratory
Scientist
Hematology
Part 2 of 4 – White Blood Cells
Brief overview
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Presented by
Nithianandan Selliah, PhD
Scientist
Founder and CEO
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Blood Smear Stain
3
Smear from Wright’s stain
A & D : Neutrophilic
B & E : Eosinophilic
C : basophilic
F : Plasma cell (not in blood)
G & H : small lymphocytes
I : medium lymphocytes
J, K & L : monocytes
Source:
Basophils, Eosinophils, Lymphocytes (T cells and B cells), Monocytes, Neutrophils
A B C
D E F
G H I
J K L

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White Blood Cells (WBC) Count
 Five major types of white blood cells: Basophils, Eosinophils,
Lymphocytes (T cells and B cells), Monocytes, Neutrophils
Normal Results
 The normal number of WBCs in the blood is 4,500-10,000 white blood cells per
microliter (mcL).
Abnormal Results: Low count
 A low number of WBCs is called leukopenia.
 It may be due to:
 Bone marrow deficiency or failure (infection, tumor, or abnormal scarring)
 Cancer treating drugs, or other medicines
 Certain autoimmune disorders such as lupus
 Disease of the liver or spleen
 Radiation treatment for cancer
 Certain viral illnesses, such as Mono
 Cancers that damage the bone marrow
 Very severe bacterial infections
 HIV infection (low CD4 T-cell count)
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White Blood Cells (WBC) Count
It may be due to:
 Anemia
 Certain drugs or medications (see list
below
 Cigarette smoking
 Infections, most often those caused by
bacteria
 Inflammatory disease (such as
rheumatoid arthritis or allergy)
 Leukemia
 Severe mental or physical stress
 Tissue damage (for example, burns)
 There may also be other less common
reasons for this result. .
 Drugs that may lower your WBC count
include:
 Antibiotics
 Anticonvulsants
 Anti thyroid drugs
 Arsenicals
 Captopril
5
 Chemotherapy drugs
 Chlorpromazine
 Clozapine
 Diuretics
 Histamine-2 blockers
 Sulfonamides
 Quinidine
 Terbinafine
 Ticlopidine
 Drugs that may increase WBC
counts include:
 Beta adrenergic agonists (for
example albuterol)
 Corticosteroids
 Epinephrine
 Granulocyte colony
stimulating factor
 Heparin
 Lithium
Abnormal Results: High count
 A high number of WBCs is called leukocytosis.

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WBC – Cytochemical Stains
 Leukocyte alkaline phosphate (lap) : neutrophils, (alkaline phosphatase)

 Myeloperoxidase stain (mps) : primary granules of myeloid cells
(peroxidase).
 Periodic acid schiff reaction (pas): stains high molecular weight
carbohydrates normally present in most blood cell types except
pronormoblasts.
 Sudan black (sbb): stains phospholipids and lipoproteins present in
granules of monocytes and granulocytes.
 Acid phosphate : stains acid phosphatase present in the lysosomes of all
hematopoietic.
 Acid phosphate with tartrates resistance: acid phosphatase present in
all hematopoietic cells, located in lysosomes.
 Nonspecific esterase stain: stains esterases in monocytes and
macrophages.
 Specific esterases (naththol AS-D chloroacetate) stain (cae): stains
esterases present in mature and immature neutrophils in mast cells.
6

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Eosinophil, Basophil &
Platelets
7 Source:

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Lymphocyte & Monocyte
8 Source:

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Lymphocyte Morphology
9
Atypical lymphocytes (in infectious
mononucleosis).
Some are very large, some have
primitive nuclei with a diffuse chromatin
pattern and nucleoli, some nuclei are
lobulated, some cells have voluminous
basophilic cytoplasm.
B lymphocytes may differentiate into
plasma cells with an increased amount of
basophilic cytoplasm, a pale-staining area
near the nucleus (the Golgi zone) and an
eccentric nucleus with clumped
chromatin. There may also be
plasmacytoid lymphocytes with
characteristics intermediate between
those of lymphocytes and plasma cells.
http://www.bloodmed.com/home/ebook.asp?book=0865427178&id=3

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Neutrophil Morphology
10
Neutrophils may also show increased lobulation
This is known as right shift.
Neutrophils with six or more lobes are said to be
hypersegmented.
Neutrophil hypersegmentation is an important
clue to the presence of deficiency of vitamin B12
or folic acid.
Increased granulation: Toxic granulation,
vacuolation and left shift (the two white cells
are band forms).
Increased granulation is usually a reaction to
infection or inflammation and is therefore
referred to as toxic granulation.

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Neutrophil Morphology
11
Decreased granulation:
A blood film of a patient showing a
myeloblast and a neutrophil. The
myeloblast has a high
nucleocytopasmic ratio, a diffuse
chromatin pattern and a single
nucleolus. The neutrophil is
hypogranular.
A neutrophil containing a Döhle body, a
small blue–grey cytoplasmic inclusion that
can be seen just below the nucleus.
Cytoplasmic inclusions may be present as
an inherited or acquired abnormality. The
commonest such abnormality is a
small, pale, blue–grey inclusion that occurs
both during pregnancy and in infection and
inflammation and is known as a Döhle
body
http://www.bloodmed.com/home/ebook.asp?book=0865427178&id=3

12. 12
PROTÉGÉ EDUCATION CENTER, LLC
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Medical Laboratory Scientist
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13. 13
PROTÉGÉ EDUCATION CENTER, LLC
Giving the Gift of Education
www.ProtegeEducation.com
Career Development Program
High school graduates & College students
SAT
PSAT
NJ ASK
Grades 3 to 12
Science Math
(Biology, Chemistry & Physics)
College
Biology, Biochemistry,
Microbiology, Immunology,
Chemistry
&
Physics
Biology Research Lab
Assistant
Certificate of Completion
Medical
Laboratory
Scientist
ASCP exam
Preparation
Presentation,
Public Speaking &
Leadership Skills
Certificate of Completion
Tutoring & Test Preparation
732-432-4900
Computer Science
Certificate of Completion

14. 14
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