Leukocytes in Peripheral Blood IMAGE PRACTICE

To those who want/need extra practice identifying leukocytes.

What is this leukocyte?

BAND NEUTROPHIL

• The nucleus is band-shaped or contains rudimentary lobes that are connected by a thick band.

• The cytoplasm is abundant, pink, and contains many small violet-pink neutrophilic or secondary granules.

• Works in the body’s defense against bacteria. Their major function is as tissue phagocytes.

What is this leukocyte?

BAND NEUTROPHIL #2

• The nucleus is band-shaped or contains rudimentary lobes that are connected by a thick band.

• The cytoplasm is abundant, pink, and contains many small violet-pink neutrophilic or secondary granules.

• Works in the body’s defense against bacteria. Their major function is as tissue phagocytes.

What is this leukocyte?

BAND NEUTROPHIL #3

• The nucleus is band-shaped or contains rudimentary lobes that are connected by a thick band.

• The cytoplasm is abundant, pink, and contains many small violet-pink neutrophilic or secondary granules.

• Works in the body’s defense against bacteria. Their major function is as tissue phagocytes.

What is this leukocyte?

SEGMENTED NEUTROPHIL (PMN)

• 10–14 µm in diameter

• The nucleus is segmented, usually 3–4 segments connected by a thin thread of chromatin that is coarse, stains violet, and is arranged in clumps.

• Small nuclear appendages may be seen.

• The cytoplasm is abundant, pink, with many small secondary granules.

• Works in the body’s defense against bacteria. Their major function is tissue phagocytes.

What is this leukocyte?

SEGMENTED NEUTROPHIL (PMN) #2

• 10–14 µm in diameter

• The nucleus is segmented, usually 3–4 segments connected by a thin thread of chromatin that is coarse, stains violet, and is arranged in clumps.

• Small nuclear appendages may be seen.

• The cytoplasm is abundant, pink, with many small secondary granules.

• Works in the body’s defense against bacteria. Their major function is tissue phagocytes.

What is this leukocyte?

SEGMENTED NEUTROPHIL (PMN) #3

• 10–14 µm in diameter

• The nucleus is segmented, usually 3–4 segments connected by a thin thread of chromatin that is coarse, stains violet, and is arranged in clumps.

• Small nuclear appendages may be seen.

• The cytoplasm is abundant, pink, with many small secondary granules.

• Works in the body’s defense against bacteria. Their major function is tissue phagocytes.

What is this leukocyte?

SEGMENTED NEUTROPHIL (PMN) #4

• 10–14 µm in diameter

• The nucleus is segmented, usually 3–4 segments connected by a thin thread of chromatin that is coarse, stains violet, and is arranged in clumps.

• Small nuclear appendages may be seen.

• The cytoplasm is abundant, pink, with many small secondary granules.

• Works in the body’s defense against bacteria. Their major function is tissue phagocytes.

What is this leukocyte?

EOSINOPHIL

• 12–17 µm in diameter.

• The nucleus is segmented, usually only two segments, with coarsely clumped, violet-staining chromatin.

• The cytoplasm is abundant, containing many eosinophilic (orange or pink) secondary granules that are larger than neutrophilic granules and more uniform in size.

• Works in the body’s defense against tissue parasites and allergic reaction.

What is this leukocyte?

EOSINOPHIL #2

• 12–17 µm in diameter.

• The nucleus is segmented, usually only two segments, with coarsely clumped, violet-staining chromatin.

• The cytoplasm is abundant, containing many eosinophilic (orange or pink) secondary granules that are larger than neutrophilic granules and more uniform in size.

• Works in the body’s defense against tissue parasites and allergic reaction.

What is this leukocyte?

EOSINOPHIL #3

• 12–17 µm in diameter.

• The nucleus is segmented, usually only two segments, with coarsely clumped, violet-staining chromatin.

• The cytoplasm is abundant, containing many eosinophilic (orange or pink) secondary granules that are larger than neutrophilic granules and more uniform in size.

• Works in the body’s defense against tissue parasites and allergic reaction.

What is this leukocyte?

EOSINOPHIL #4

• 12–17 µm in diameter.

• The nucleus is segmented, usually only two segments, with coarsely clumped, violet-staining chromatin.

• The cytoplasm is abundant, containing many eosinophilic (orange or pink) secondary granules that are larger than neutrophilic granules and more uniform in size.

• Works in the body’s defense against tissue parasites and allergic reaction.

What is this leukocyte?

BASOPHIL

• 10–16 µm in diameter.

• The nucleus is segmented but is often obscured by basophilic granules.

• The cytoplasm is pale blue, containing purple-black secondary granules that can vary in number, size, and shape. The granules are water-soluble and may dissolve on staining, leaving clear areas in the cytoplasm.

• Works in the body’s defense against allergic and inflammatory agents.

What is this leukocyte?

BASOPHIL #2

• 10–16 µm in diameter.

• The nucleus is segmented but is often obscured by basophilic granules.

• The cytoplasm is pale blue, containing purple-black secondary granules that can vary in number, size, and shape. The granules are water-soluble and may dissolve on staining, leaving clear areas in the cytoplasm.

• Works in the body’s defense against allergic and inflammatory agents.

What is this leukocyte?

BASOPHIL #3

• 10–16 µm in diameter.

• The nucleus is segmented but is often obscured by basophilic granules.

• The cytoplasm is pale blue, containing purple-black secondary granules that can vary in number, size, and shape. The granules are water-soluble and may dissolve on staining, leaving clear areas in the cytoplasm.

• Works in the body’s defense against allergic and inflammatory agents.

What is this leukocyte?

SMALL LYMPH

• 8–12 µm in diameter with high N:C ratio.
• The nucleus is round with coarse, dense chromatin.
• The cytoplasm is narrow, weakly basophilic, homogenous, and clear without inclusions.
• Works in the body’s defense against viral infections.

What is this leukocyte?

SMALL LYMPH #2

• 8–12 µm in diameter with high N:C ratio.
• The nucleus is round with coarse, dense chromatin.
• The cytoplasm is narrow, weakly basophilic, homogenous, and clear without inclusions.
• Works in the body’s defense against viral infections.

What is this leukocyte?

SMALL LYMPH #3

• 8–12 µm in diameter with high N:C ratio.
• The nucleus is round with coarse, dense chromatin.
• The cytoplasm is narrow, weakly basophilic, homogenous, and clear without inclusions.
• Works in the body’s defense against viral infections.

What is this leukocyte?

SMALL LYMPH #4

• 8–12 µm in diameter with high N:C ratio.
• The nucleus is round with coarse, dense chromatin.
• The cytoplasm is narrow, weakly basophilic, homogenous, and clear without inclusions.
• Works in the body’s defense against viral infections.

What is this leukocyte?

LARGE LYMPH

• 12–16 µm in diameter with an irregular outline.

• The nuclear can appear irregular and the chromatin is not as coarse as in small lymphocytes.

• The cytoplasm is abundant and tends to be light blue.

• Works in the body’s defense against viral infections.

What is this leukocyte?

LARGE LYMPH #2

• 12–16 µm in diameter with an irregular outline.

• The nuclear can appear irregular and the chromatin is not as coarse as in small lymphocytes.

• The cytoplasm is abundant and tends to be light blue.

• Works in the body’s defense against viral infections.

What is this leukocyte?

LARGE LYMPH #3

• 12–16 µm in diameter with an irregular outline.

• The nuclear can appear irregular and the chromatin is not as coarse as in small lymphocytes.

• The cytoplasm is abundant and tends to be light blue.

• Works in the body’s defense against viral infections.

What is this leukocyte?

LARGE LYMPH #4

• 12–16 µm in diameter with an irregular outline.

• The nuclear can appear irregular and the chromatin is not as coarse as in small lymphocytes.

• The cytoplasm is abundant and tends to be light blue.

• Works in the body’s defense against viral infections.

What is this leukocyte?

MONOCYTE

• 15–22 µm in diameter. Largest cell in peripheral blood.

• The nucleus is irregular in outline, often kidney-shaped, and the chromatin is arranged in fine strands with sharply defined margins.

• The cytoplasm is light blue-grey and contains numerous fine dust-like granules.

• Vacuolation may be present.

• Works in the body’s defense against bacterial and fungal infections.

• Mainly differentiates into long-lived tissues macrophages.

What is this leukocyte?

MONOCYTE #2

• 15–22 µm in diameter. Largest cell in peripheral blood.

• The nucleus is irregular in outline, often kidney-shaped, and the chromatin is arranged in fine strands with sharply defined margins.

• The cytoplasm is light blue-grey and contains numerous fine dust-like granules.

• Vacuolation may be present.

• Works in the body’s defense against bacterial and fungal infections.

• Mainly differentiates into long-lived tissues macrophages.

What is this leukocyte?

MONOCYTE #3

• 15–22 µm in diameter. Largest cell in peripheral blood.

• The nucleus is irregular in outline, often kidney-shaped, and the chromatin is arranged in fine strands with sharply defined margins.

• The cytoplasm is light blue-grey and contains numerous fine dust-like granules.

• Vacuolation may be present.

• Works in the body’s defense against bacterial and fungal infections.

• Mainly differentiates into long-lived tissues macrophages.

What is this leukocyte?

MONOCYTE #4

• 15–22 µm in diameter. Largest cell in peripheral blood.

• The nucleus is irregular in outline, often kidney-shaped, and the chromatin is arranged in fine strands with sharply defined margins.

• The cytoplasm is light blue-grey and contains numerous fine dust-like granules.

• Vacuolation may be present.

• Works in the body’s defense against bacterial and fungal infections.

• Mainly differentiates into long-lived tissues macrophages.

What is this neutrophil showing?

HYPERSEGMENTATION

• Hypersegmented neutrophils have an increased number of distinct nuclear lobes with increased numbers of neutrophils having five or more nuclear segments.

• Hypersegmented neutrophils have a correlation with Megaloblastic anemias.

What is this neutrophil showing?

HYPERSEGMENTATION #2

• Hypersegmented neutrophils have an increased number of distinct nuclear lobes with increased numbers of neutrophils having five or more nuclear segments.

• Hypersegmented neutrophils have a correlation with Megaloblastic anemias.

What is this neutrophil showing?

HYPERSEGMENTATION #3

• Hypersegmented neutrophils have an increased number of distinct nuclear lobes with increased numbers of neutrophils having five or more nuclear segments.

• Hypersegmented neutrophils have a correlation with Megaloblastic anemias.

What is this neutrophil showing?

HYPERSEGMENTATION #4

• Hypersegmented neutrophils have an increased number of distinct nuclear lobes with increased numbers of neutrophils having five or more nuclear segments.

• Hypersegmented neutrophils have a correlation with Megaloblastic anemias.

What is this neutrophil showing?

HYPOSEGMENTATION

• Hyposegmented are mature neutrophils and can be differentiated by their smaller nucleus and lower nuclear-to-cytoplasmic (N:C) ratio, along with condensed nuclear chromatin.

• Hyposegmented neutrophils are marked by the failure of normal nuclear lobe development during terminal differentiation and have coarse, clumped nuclear chromatin.

What is this neutrophil showing?

HYPOSEGMENTATION #2

• Hyposegmented are mature neutrophils and can be differentiated by their smaller nucleus and lower nuclear-to-cytoplasmic (N:C) ratio, along with condensed nuclear chromatin.

• Hyposegmented neutrophils are marked by the failure of normal nuclear lobe development during terminal differentiation and have coarse, clumped nuclear chromatin.

What is this neutrophil showing?

HYPOSEGMENTATION #3

• Hyposegmented are mature neutrophils and can be differentiated by their smaller nucleus and lower nuclear-to-cytoplasmic (N:C) ratio, along with condensed nuclear chromatin.

• Hyposegmented neutrophils are marked by the failure of normal nuclear lobe development during terminal differentiation and have coarse, clumped nuclear chromatin.

What is this neutrophil showing?

TOXIC GRANULATION

• Hypergranulated neutrophils contain coarse, dark-purple primary (azurophilic) granules that appear as a reactive response to infection or inflammation.

• This is a non-specific change caused by abnormal maturation of primary granules, leading to retention of their azurophilic staining properties.

What is this neutrophil showing?

TOXIC GRANULATION #2

• Hypergranulated neutrophils contain coarse, dark-purple primary (azurophilic) granules that appear as a reactive response to infection or inflammation.

• This is a non-specific change caused by abnormal maturation of primary granules, leading to retention of their azurophilic staining properties.

What is this neutrophil showing?

TOXIC GRANULATION #3

• Hypergranulated neutrophils contain coarse, dark-purple primary (azurophilic) granules that appear as a reactive response to infection or inflammation.

• This is a non-specific change caused by abnormal maturation of primary granules, leading to retention of their azurophilic staining properties.

What is this neutrophil showing?

TOXIC GRANULATION #4

• Hypergranulated neutrophils contain coarse, dark-purple primary (azurophilic) granules that appear as a reactive response to infection or inflammation.

• This is a non-specific change caused by abnormal maturation of primary granules, leading to retention of their azurophilic staining properties.

What is this neutrophil showing?

HYPOGRANULATION

• Hypogranulated neutrophils show reduced or absent cytoplasmic granules, giving mature neutrophils a smooth blue-grey appearance on the smear.

What is this neutrophil showing?

HYPOGRANULATION #2

• Hypogranulated neutrophils show reduced or absent cytoplasmic granules, giving mature neutrophils a smooth blue-grey appearance on the smear.

What is this neutrophil showing?

HYPOGRANULATION #3

• Hypogranulated neutrophils show reduced or absent cytoplasmic granules, giving mature neutrophils a smooth blue-grey appearance on the smear.

What is this leukocyte showing?

REACTIVITY

• Reactive lymphocyte is used to describe lymphocytes with a benign etiology.

• Abnormalities include increased cell size, immaturity of the nucleus including a visible nucleolus and lack of chromatin condensation.

• The nuclear outline can be irregular or present with lobulation.

• The cytoplasm appears basophilic, can contain vacuolation and have an irregular cell outline.

• Reactive lymphocytes have a tendency to surround adjacent cells and can be seen in viral infections.

What is this leukocyte showing?

REACTIVITY #2

• Reactive lymphocyte is used to describe lymphocytes with a benign etiology.

• Abnormalities include increased cell size, immaturity of the nucleus including a visible nucleolus and lack of chromatin condensation.

• The nuclear outline can be irregular or present with lobulation.

• The cytoplasm appears basophilic, can contain vacuolation and have an irregular cell outline.

• Reactive lymphocytes have a tendency to surround adjacent cells and can be seen in viral infections.

What is this leukocyte showing?

REACTIVITY #3

• Reactive lymphocyte is used to describe lymphocytes with a benign etiology.

• Abnormalities include increased cell size, immaturity of the nucleus including a visible nucleolus and lack of chromatin condensation.

• The nuclear outline can be irregular or present with lobulation.

• The cytoplasm appears basophilic, can contain vacuolation and have an irregular cell outline.

• Reactive lymphocytes have a tendency to surround adjacent cells and can be seen in viral infections.

What is this leukocyte showing?

REACTIVITY #4

• Reactive lymphocyte is used to describe lymphocytes with a benign etiology.

• Abnormalities include increased cell size, immaturity of the nucleus including a visible nucleolus and lack of chromatin condensation.

• The nuclear outline can be irregular or present with lobulation.

• The cytoplasm appears basophilic, can contain vacuolation and have an irregular cell outline.

• Reactive lymphocytes have a tendency to surround adjacent cells and can be seen in viral infections.

What is this leukocyte?

ABNORMAL LYMPH

• Abnormal lymphocyte with an accompanying description of the cells is used to describe lymphocytes with a suspected malignant or clonal etiology.

• Examples of abnormal lymphocytes are Hairy cells, Sézary cells, lymphoma cells, and prolymphocytes.

What is this leukocyte?

ABNORMAL LYMPH #2

• Abnormal lymphocyte with an accompanying description of the cells is used to describe lymphocytes with a suspected malignant or clonal etiology.

• Examples of abnormal lymphocytes are Hairy cells, Sézary cells, lymphoma cells, and prolymphocytes.

What is this?

AUER RODS

• Auer rods are sharply defined red rod or needle-like cytoplasmic inclusion formed by abnormal primary granule development.

• There may be several in a cell and may be arranged in bundles.

• Auer rods are mainly found in leukemic myeloblasts or abnormal promyelocytes.

• Auer rods can be found in Acute Myelocytic Leukemia (AML).

What is this?

AUER RODS #2

• Auer rods are sharply defined red rod or needle-like cytoplasmic inclusion formed by abnormal primary granule development.

• There may be several in a cell and may be arranged in bundles.

• Auer rods are mainly found in leukemic myeloblasts or abnormal promyelocytes.

• Auer rods can be found in Acute Myelocytic Leukemia (AML).

What is this?

AUER RODS #3

• Auer rods are sharply defined red rod or needle-like cytoplasmic inclusion formed by abnormal primary granule development.

• There may be several in a cell and may be arranged in bundles.

• Auer rods are mainly found in leukemic myeloblasts or abnormal promyelocytes.

• Auer rods can be found in Acute Myelocytic Leukemia (AML).

What is this leukocyte?

HAIRY CELL

• Hairy cells are larger than normal lymphocytes and have abundant pale blue-grey cytoplasm with fine hair-like projections.

• The nucleus varies in shape and may be round, oval, bean-shaped or bilobed.

• Hairy cell leukemia is a chronic B cell lineage leukemia with morphologically distinctive neoplastic cells.

What is this leukocyte?

HAIRY CELL #2

• Hairy cells are larger than normal lymphocytes and have abundant pale blue-grey cytoplasm with fine hair-like projections.

• The nucleus varies in shape and may be round, oval, bean-shaped or bilobed.

• Hairy cell leukemia is a chronic B cell lineage leukemia with morphologically distinctive neoplastic cells.

What is this leukocyte?

HAIRY CELL #3

• Hairy cells are larger than normal lymphocytes and have abundant pale blue-grey cytoplasm with fine hair-like projections.

• The nucleus varies in shape and may be round, oval, bean-shaped or bilobed.

• Hairy cell leukemia is a chronic B cell lineage leukemia with morphologically distinctive neoplastic cells.

What is this leukocyte?

SEZARY CELL

• Sezary cells can vary in size.

• The nuclear morphology, classically described as cerebriform, is the characteristic cytological feature of sezary cells.

• The nucleus has deep narrow clefts with superimposed and folded lobes giving it a very convoluted appearance.

• Sezary syndrome is a mature T-cell lymphoma with neoplastic T lymphocytes in the peripheral blood.

What is this leukocyte?

SEZARY CELL #2

• Sezary cells can vary in size.

• The nuclear morphology, classically described as cerebriform, is the characteristic cytological feature of sezary cells.

• The nucleus has deep narrow clefts with superimposed and folded lobes giving it a very convoluted appearance.

• Sezary syndrome is a mature T-cell lymphoma with neoplastic T lymphocytes in the peripheral blood.

What is this leukocyte?

SEZARY CELL #3

• Sezary cells can vary in size.

• The nuclear morphology, classically described as cerebriform, is the characteristic cytological feature of sezary cells.

• The nucleus has deep narrow clefts with superimposed and folded lobes giving it a very convoluted appearance.

• Sezary syndrome is a mature T-cell lymphoma with neoplastic T lymphocytes in the peripheral blood.

What characteristics is this neutrophil showing?

DÖHLE BODIES

• Döhle bodies are pale light blue or grey, single or multiple, cytoplasmic inclusions found near the periphery of the neutrophil.

• Döhle bodies are a non-specific reactive change but may also indicate May-Hegglin anomaly if associated with thrombocytopenia and giant platelets.

What characteristics is this neutrophil showing?

DÖHLE BODIES #2

• Döhle bodies are pale light blue or grey, single or multiple, cytoplasmic inclusions found near the periphery of the neutrophil.

• Döhle bodies are a non-specific reactive change but may also indicate May-Hegglin anomaly if associated with thrombocytopenia and giant platelets.

What characteristics is this neutrophil showing?

DÖHLE BODIES #3

• Döhle bodies are pale light blue or grey, single or multiple, cytoplasmic inclusions found near the periphery of the neutrophil.

• Döhle bodies are a non-specific reactive change but may also indicate May-Hegglin anomaly if associated with thrombocytopenia and giant platelets.

What characteristics is this neutrophil showing?

PEGLER HUËT ABNORMALITY

• Pelger Huët is an inherited or acquired (pseudo-Pelger-Huët) anomaly.

• It is characterized by decreased nuclear segmentation and a coarse chromatin clumping pattern of the Neutrophils.

What characteristics is this neutrophil showing?

PEGLER HUËT ABNORMALITY #2

• Pelger Huët is an inherited or acquired (pseudo-Pelger-Huët) anomaly.

• It is characterized by decreased nuclear segmentation and a coarse chromatin clumping pattern of the Neutrophils.

What characteristics is this neutrophil showing?

PEGLER HUËT ABNORMALITY #3

• Pelger Huët is an inherited or acquired (pseudo-Pelger-Huët) anomaly.

• It is characterized by decreased nuclear segmentation and a coarse chromatin clumping pattern of the Neutrophils.

What characteristics is this neutrophil showing?

PEGLER HUËT ABNORMALITY #4

• Pelger Huët is an inherited or acquired (pseudo-Pelger-Huët) anomaly.

• It is characterized by decreased nuclear segmentation and a coarse chromatin clumping pattern of the Neutrophils.