Role of peripheral blood
•Descargar como PPT, PDF•
25 recomendaciones•2,419 vistas
In the work-up of a disease, the peripheral smear gives a very good information of what disease the patient may be suffering from. It also gives direction for further evaluation, all impacting the treatment and well being of the patient.
Recomendados
Más contenido relacionado
La actualidad más candente
La actualidad más candente (20)
Destacado
Destacado (20)
Similar a Role of peripheral blood
Similar a Role of peripheral blood (20)
Último
Último (20)
Role of peripheral blood
- 1. Role of Peripheral blood smear examination in diagnostic work-up Dr K Richards MD(Path);DTCD Consultant Pathologist- Hematology Yashoda Hospital
- 2. Why do a peripheral blood film examination?
- 10. Anisocytosis • abnormal erythropoiesis • non-specific feature • either macrocytes or microcytes or both
- 11. Poikilocytosis • abnormal erythropoiesis • non-specific feature • megaloblastic anemia, • iron deficiencyanemia, • thalassemia, • myelofibrosis, • MDS • Congenital dyserythropoietic anemia
- 12. Microcytes • defect in hemoglobin formation • characteristic of iron deficiency anemia • thalassemia • severe cases of anemia of chronic disease • sideroblastic anemias
- 13. Macrocytes • classical in megaloblastic anemia • aplastic anemia • MDS • Alcoholics • Chronic liver disease • Hydroxyurea
- 14. Basophilic stippling • thalassemias, • megaloblastic anemia • infections • liver disease • lead poisoning • unstable hemoglobins • pyrimidine-5- nucleotidase deficiency
- 15. Hypochromasia • iron deficiency anemia • sideroblastic anemia • thalassemias
- 16. Dimorphic Red Cell Population • two distinct populations • development or resolution of IDA or anemia of chronic deficiency • post blood transfusion • acquired sideroblastic anemia
- 17. Spherocytes • hereditary spherocytosis • ABO hemolytic disease of the newborn • autoimmune hemolytic anemia • microspherocytes • sphero-echinocytes
- 18. Elliptocytes and Ovalocytes • hereditary elliptocytosis • hereditary pyropoikilocytosis • southeast asian ovalocytosis
- 19. Schistocytes • RBC fragments • thalassemias • CDA • Megaloblastic anemia • microangiopathic hemolytic anemia • severe burns • hemolytic uremic syndrome(HUS) • thrombotic thrombocytopenic purpura(TTP)
- 20. Acanthocytes • Abnormal phospholipid metabolism • McLeod phenotype • Splenectomy • hyposplenism • Severe Liver disease
- 21. Crenated RBC/Echinocytes • healthy subjects • storage artefact • uremia • cardiopulmonary bypass • premature infants
- 22. Target Cells • iron deficiency anemia • thalassemia • sickle cell anemia • Hemoglobinopathies • Chronic liver disease • splenectomy • Hereditary hypobetalipoproteine mia
- 23. Stomatocytes • Liver disease • alcoholics • MDS
- 24. Sickle Cells • Sickling: blood subjected to anoxia • Sickles and boat shaped forms • Target cells – often a feature
- 27. Polychromasia • Shades of bluish grey • Reticulocytes • Increased erythropoiesis • Absence of polychromasia -inadequate bone marrow response Aplastic anemia Pure red cell aplasia
- 28. Nucleated RBCs • More common in children • Severe anemia • Hemolytic disease of newborn • Leucoerythroblastic anemia:carcinomatoses and primary myelofibrosis • Post splenectomy • Extramedullary erythropoiesis • Sickle cell anemia • Septicemia • Cyanotic heart failure
- 29. Erythrocyte Inclusions: Howell Jolly Bodies • Nuclear remnants • Small round, stain purple • Post splenectomy • Splenic atrophy
- 30. Erythrocyte inclusions: Pappenheimer bodies • Small, peripherally sited basophilic/ almost black • Smaller than howell-jolly inclusions • Composed of hemosiderin • Related to Sideroblastic erythropoiesis and hyposplenism • Confirmed by perls’ stain • Correspond to siderotic granules of siderocytes
- 35. Toxic granulation and Cytoplasmic Vacuolation • Bacterial infection • Other causes of inflammation • Administration of Granulocyte colony stimulating factor
- 36. • Poorly staining (hypogranular) • Agranular neutrophils • Myelodysplastic syndromes • Some forms of myeloid leukemia
- 37. Chediak Higashi syndrome: • Abnormal granules • Giant but scanty azurophilic granules • Functional defect • Susceptibility to severe infection
- 38. Alder Reilly Anomaly: • Nucleus is obscured by cytoplasmic granules • Neutrophils function normally
- 39. Pelger-Huet Cells • Benign inherited condition • Pseudo pelger huet cells: MDS, AML with dysplastic maturation, chronic myeloid leukemia
- 40. Hypersegmented Nuclei • Megaloblastic anemia • Uremia • Iron deficiency anemia • Cytotoxic treatment – methotrexate • Hydroxycarbamide
- 41. Left Shift
- 42. Basophilia • Rarest (<1%) • Myeloproliferative neoplasms • CML: >10% impending accelerated phase/blast crisis
- 43. Eosinophilia • Eosinopenia: prolonged steroid administration • Eosinophilia: - Allergic conditions, - parasitic infections, - reactive eosinophilias ( Lymphomas, ALL) - eosinophilic leukemia, - idiopathic hypereosinophilic syndrome, - CML, - AML
- 44. Monocytes • Chronic infections and inflammatory conditions like TB, Crohn’s disease • Atypical CML, CMML • Acute leukemia with monocytic component
- 45. Lymphocytes • Transformed lymphocytes: viral and bacterial lymphocytes • Immunoblasts or turk cells
- 50. Large/Giant platelets Large Platelets: • Increased platelet production • Hyposplenism • Severe immune thrombocytopenia
- 51. Thrombocytosis • Acute inflammatory stress • Bleeding • Critically ill patient • Hyposplenism • Myeloproliferative neoplasm
- 52. Grey platelet syndrome: • Hypogranular platelets
- 53. Platelet satellitism • antiplatelet autoantibodies • Apparently healthy individuals
- 54. Hemoparasites
- 57. Summary • Simple • morphology • Basic and foundational • Further direction • Patient management
- 58. References • Dacie and Lewis practical hematology – 11th edition • Wintrobe’s clinical hematology – 13th edition
- 59. Thank you