124 WBC Weekend Lab

low power scan (10x)

• eval overall stain quality

• eval cell distribution

• determine optimal exam area

high power scan (40x)

• wbc estimation

oil immersion (100x)

• eval RBC morphology

• platelet estimation

• wbc differential

optimal exam area of a blood smear

monolayer of cells

method for wbc differential on blood smear

battlement pattern

neutrophil band

segmented neutrophil

segmented eosinophil

segmented basophil

monocyte

thrombocyte (platelet)

lymphocyte

reactive lymphocyte

myeloblast

promyelocyte

neutrophilic myelocyte

neutrophilic metamyelocyte

neutrophil maturation (myelopoiesis)

1. myeloblast

2. promyelocyte

3. myelocyte

4. metamyelocyte

5. neutrophilic band

6. segmented neutrophil

plasma cell

megakaryocyte

rubriblast (rbc)

wright stain steps

1. methanol - fixes cells to slide

2. eosin - has affinity for basic components (stains red)

3. methylene blue - has affinity for acidic components (stains blue)

wbc count estimation calculation

avg. # of wbc/HPF

• count in 10 areas then divide by 10 to get avg.

wbc count estimation

• 2-4 WBC → 4-7k/uL

• 4-6 WBC → 7k10k/uL

• 6-10 WBC → 10-13k/uL

• 10-20 WBC → 13-18k/uL

platelet count estimation

• count # of platelets in 10 HPF areas

• multiply avg. by 2000 = plt/uL

thrombocytosis

> 20 plt/uL

thrombocytopenia

< 20 plt/uL

wbc differential

identify 100 wbcs in hpf

bone marrow differential

identify ~500 NUCLEATED cells

sickledex procedure

1. 4 mL phosphate buffer to tube containing sodium hydrosulfite

2. 50 uL patient sample to tube

3. cap & shake

4. incubate at room temp. for 10-20 min.

5. read tube against black lines

monospot assay

detects heterophile antibodies

monospot procedure

1. 1 drop patient sample

2. 1 drop diluent

3. place strip in tube w/ sample

4. wait 5 min.

pelger-huet anomaly

alder’s anomaly

chediak-higashi syndrome

may-hegglin anomaly

gaucher cell

niemann-pick cell

sea-blue histiocyte

MPO stain

SBB stain

PAS stain

CAE stain

NSE stain

LAP stain

TRAP stain

waldenstrom’s macroglobulinemia

• flame cells

• dutcher bodies

reed-sternberg cell in hodgkin’s lymphoma

multiple myeloma (excess production of plasma cells)

sezary cell

burkitt’s lymphoma

chronic leukemia

acute leukemia