Слайд 2
Все клетки, которые можно встретить в костном мозге
в норме и при патологии можно разделить на следующие
основные группы:
1. Клетки ретикулярной стромы (не принимают непосредственного участия в кроветворении, но имеют большое значение, т. к. создают необходимое микроокружение для кроветворных клеток). К ним относятся:
ретикулярные клетки;
клетки эндотелия;
остеобласты;
жировые клетки.
Слайд 3
Ретикулярные клетки
Reticular cells, polychromatic NRBCs, normal marrow
Two
reticular cells (center), 4 lymphocytes, 5 polychromatic NRBCs, 1
segmented neutrophil, 1 smudge cell. Normal marrow - 100X
Слайд 4
Ретикулярные клетки
Reticular cell, normal marrow
One reticular cell.
Normal marrow - 100X
Слайд 5
Ретикулярные клетки
Reticular cell, neutrophilic myelocyte, normal marrow
One
reticular cell, 1 neutrophilic myelocyte. Normal marrow - 100X
Слайд 6
Клетки эндотелия
Endothelial cells.
Strand of endothelial cells. Normal
marrow -20X
Слайд 7
Клетки эндотелия
Endothelial cells
Higher magnification of strand of
endothelial cells. Normal marrow - 100X
Слайд 8
Остеобласты
Osteoblasts
Clump of osteoblasts. Normal marrow particle preparation
-50X Osteoblast are large in size, often are oval
in shape, have an eccentrically located nucleus which appears to be falling out of the cell, blue-gray cytoplasm with a clear area away from the nucleus.
Слайд 9
Остеобласты
Osteoblasts, Normal marrow
Same clump of osteoblasts. Normal
marrow particle preparation -100X
Слайд 10
Остеобласты
Рlasma cell, osteoblasts
One small and 1 large
plasma cell in top left frame. 2 osteoblasts in
top right frame, 1 osteoblast in lower frame. Normal marrow -100X
Слайд 11
Жировые клетки
Fat cells. Aplastic anemia marrow
Multiple fat
cells. Aplastic anemia marrow -20X
Слайд 12
Жировые клетки
Fat cells, Aplastic anemia marrow
Two very
large fat cells. Aplastic anemia marrow -50X
Слайд 13
2. Миелокариоциты - клетки кроветворной ткани костного мозга
с их производными - зрелыми клетками крови. К ним
относятся:
недифференцированные бласты;
клетки миелоцитарного ряда;
клетки моноцитарного ряда;
клетки лимфоцитарного ряда;
клетки эритроцитарного ряда;
клетки мегакариоцитарного ряда.
Слайд 15
Миелобласт
Myeloblast, late neutrophil, normal marrow
One myeloblast, 1 late
neutrophil. Normal marrow - 100X
Слайд 16
Миелобласт
Myeloblast, neutrophilic metamyelocyte, normal marrow
One myeloblast, 1 neutrophilic
metamyelocyte. Normal marrow - 100X
Слайд 17
Миелобласт
Myeloblast, late NRBC, normal marrow
One myeloblast / monoblast,
1 late NRBC. Normal marrow - 100X
Слайд 18
Progranulocyte, band neutrophils
One late progranulocyte, 2 band neutrophils.
Normal marrow - 100X
Слайд 19
Progranulocyte, band neutrophils, normal marrow
One progranulocyte, 2 band
neutrophils. Normal marrow - 100X
Слайд 20
Progranulocyte, myelocyte, normal marrow
One progranulocyte, 1 myelocyte. Normal
marrow - 100X
Слайд 21
Late neutrophilic myelocyte, normal marrow
One late neutrophilic myelocyte.
Normal marrow - 100X
Слайд 22
Neutrophilic myelocyte, normal marrow
One neutrophilic myelocyte. Normal marrow
- 100X
Слайд 23
Myelocytes, abnormal platelets, AML blood
Two myelocytes, one with
and the other without primary or coarse azurophilic granules.
Both contain vacuoles. Their nuclear chromatin is showing some heterochromatin deveopment. Several abnormal (agranular) platelets are present. Acute Megakaryocytic Leukemia (M-7). Blood - 100
Слайд 24
Myelocyte, disrupted band neutrophil
One early myelocyte with many
azure granules, 1 disrupted band neutrophil. Normal marrow -
100X
Слайд 25
Eosinophilic myelocyte, Normal marrow
Left frame: 1 normal eosinophilic
myelocyte. Center frame: 1 eosinophilic myelocyte with large blue
and large eosinophilic granules. Right frame: 1 eosinophilic myelocyte with large blue granules and large eosinophilic granules. Normal marrow - 100X
Слайд 26
Eosinophilic myelocyte, neutrophilic myelocyte
One eosinophilic myelocyte (lower left),
1 neutrophilic myelocyte, 1 segmented neutrophil, 1 late NRBC.
Normal marrow - 100X
Слайд 27
Eosinophilic myelocyte, eosinophilic metamyelocyte, mitosis
One eosinophilic myelocyte (left),
1 eosinophilic metamyelocyte (lower right), 1 eosinophilic band (top
right), 1 intermediate (myelocyte) eosinophil in mitosis, 1 neutrophilic myelocyte. Normal marrow - 100X
Слайд 28
Eosinophilic myelocyte, neutrophilic myelocytes
One eosinophilic myelocyte (left), 2
neutrophilic myelocytes. Normal marrow - 100X
Слайд 29
Metamyelocyte, normal marrow
One metamyelocyte - late. Normal marrow
- 100X
Слайд 30
Metamyelocyte, smudge cell, normal marrow
One metamyelocyte, 1 smudge
cell. Normal marrow - 100X
Слайд 31
Metamyelocyte, smudge cell, normal marrow
One metamyelocyte - early,
1 smudge cell. Normal marrow - 100X
Слайд 32
Metamyelocyte, neutrophilic myelocyte, normal marrow
One metamyelocyte - early,
1 neutrophilic myelocyte. Normal marrow - 100X
Слайд 33
Eosinophilic myelocyte, eosinophilic metamyelocyte, mitosis
One eosinophilic myelocyte (left),
1 eosinophilic metamyelocyte (lower right), 1 eosinophilic band (top
right), 1 intermediate (myelocyte) eosinophil in mitosis, 1 neutrophilic myelocyte. Normal marrow - 100X
Слайд 34
Band neutrophils, monocyte
Three band neutrophils, 1 monocyte (top
left center) Note differences in chromatin and cytoplasmic color
- 100X
Слайд 35
Band neutrophils
Three band neutrophils - 100X
Слайд 36
Band eosinophil, mature neutrophil, Normal blood
One band eosinophil,
1 mature neutrophil. Normal blood - 100X
Слайд 37
Mature Neutrophils, Platelet Satellitism
One huge clump of nine
Mature Neutrophils, each of which is surrounded by platelets.
It is probably the stickiness of the platelets for each other that enhances this clumping. The white cell count may be erroneously low in such cases. Platelet Satellitism. EDTA blood - 100X
Слайд 38
Young megakaryocyte, neutrophilic myelocytes, normal marrow
Young megakaryocyte showing
early granulation adjacent to lobulated nuclei. 1 progranulocyte, 2
neutrophilic myelocytes, 1 eosinophilic myelocyte, 1 neutrophilic metamyelocyte, 2 band and 2 segmented neutrophils and 3 late NRBC surround it. Normal marrow - 100X
Слайд 39
Segmented neutrophils, band neutrophils, normal blood
Segmented neutrophils and
band neutrophils composite; 2 band neutrophils (top frames) and
2 segmented neutrophils (lower frame). Normal blood - 100X
Слайд 40
Eosinophil, Normal blood
One 3-lobed eosinophil, 1 2-lobed eosinophil,
2 mature neutrophils; composite. Normal blood - 100X
Слайд 41
Basophils, mature neutrophils, CML blood
Three mature basophils, 2
mature neutrophils. Chronic myeloid leukemia blood - 100X
Слайд 42
Basophil
One mature basophil. Normal blood - 100X
Слайд 45
Young monocyte, normal blood
One young monocyte with immature
chromatin and nucleoli. Normal blood - 100X
Слайд 46
Immature Monocytes, cytoplasmic fragmentation, M-5
Two Immature Monocytes, one
of which shows cytoplasmic fragmentation. These fragments resemble Platelets
and may be erroneously counted as such. The two fragments to the right of the monocytes may be real platelets. Acute Monocytic Leukemia ( M-5). Blood - 100X
Слайд 47
Young monocytes, normal blood
Two young monocytes, 1 with
many vacuoles. Normal blood - 100X
Слайд 48
Macrophage, mature megakaryocyte, normal marrow
A macrophage with an
oval shaped nucleus and a highly vacuolated cytoplasm containing
a NRBC and a few scattered azure granules is at left center. A mature megakaryocyte with a single large nucleus and a fully granulated cytoplasm lies to its right. Normal marrow - 100X
Слайд 49
Osteoclast
One osteoclast with 12 nuclei. Normal marrow -100X
Слайд 50
Very small lymphocyte, monocyte, normal blood
One very small
lymphocyte, 1 monocyte. Normal blood - 50X
Слайд 51
Lymphocytes, normal blood
Two lymphocytes (1 with granules); Normal
blood - 100X
Слайд 52
Large reactive lymphocyte, normal blood
One very large lymphocyte
(reactive); Normal blood - 100X
Слайд 53
Monocyte, large lymphocyte, normal blood
One monocyte (left), 1
large lymphocyte. Normal blood - 100X
Слайд 55
Plasmacytoid lymphoid, infectious mononucleosis blood
One small mature lymphocyte,
1 Plasmacytoid Lymphoid with a contorted nucleus. Infectious mononucleosis
blood - 100X
Слайд 56
Plasmacytoid lymphocyte, severe arthritis with osteoporosis
Left frame: 1
Plasmacytoid Lymphocyte with a double nucleus, 1 mature neutrophil.
Center
frame: 1 mature lymphocyte and 1 small Plasmacytoid Lymphocyte.
Right frame: 1 Plasmacytoid Lymphocyte with a contorted nucleus and 1 late smudged form.
Severe arthritis with osteoporosis blood - 100X
Слайд 57
Monocyte, Plasmacytoid Lymphocyte, drug reaction buffy coat
One monocyte,
1 Plasmacytoid Lymphocyte and 1 eosinophil. Drug reaction buffy
coat preparation - 100X
Слайд 58
Plasma cell, alcoholic, liver disease
One monocyte at left
edge and one Plasma Cell at right edge. The
plasma cell is medium in size, has an eccentrically located nucleus which shows a dense chromatin with a few randomly located open areas. The abundant cytoplasm is very basophilic blue, contains a few vacuoles and shows an almost colorless area (Golgi) adjacent to the nucleus. Alcoholic with liver disease blood - 100X
Слайд 59
Plasma Cell
One large Plasma Cell, oval in shape,
with an eccentrically located nucleus, a very low nuclear/cytoplasm
ratio, a gray-blue cytoplasm containing several vacuoles of variable size. The nuclear chromatin is dense with several clear areas randomly distributed. Normal marrow - 100X
Слайд 61
Plasma cells, proerythroblast, NRBC
Two Plasma Cells with low
nuclear/cytoplasmic ratio, deep basophilic blue cytoplasm, distinct clear area
adjacent to the nucleus and eccentrically located nucleus. At the center top edge is a Proerythroblast with a high nuclear/cytoplasmic ratio but deep basophlic blue cytoplasm and dense nuclear chromatin similar to the plasma cells. Its clear area (Golgi) adjacent to the nucleus is not as pronounced as in the plasma cells. 1 late NRBC is at left center as well as a 5-lobed mature neutrophil. Normal marrow - 100X
Слайд 62
Plasma cell, proerythroblast
One Plasma Cell and 1 Proerythroblast.
Early erythroblasts have a deep blue cytoplasm, and a
coarse nuclear chromatin similar to plasma cells, but differ in having a high nuclear/cytoplasmic ratio and a centrally located nucleus in a round shaped cell. Also, they usually lack cytoplasmic vacuoles. Normal marrow - 100X
Слайд 63
Mature lymphocyte, proerythroblast, basophilic erythroblast
Слайд 64
Late NRBC, Mature Lymphocyte, AML
One Late NRBC at
upper left and one Mature Lymphocyte at lower right.
Many platelets are scattered throughout the field. An Abnormal Megathrombocyte, which is huge, irregular in shape and agranular, is at the left center. Acute Megakaryocytic Leukemia (M-7) untreated. Blood - 50X
Слайд 65
Blasts, polychromatic nrbcs, acute megakaryocytic leukemia
Two Blasts of
medium size with fine nuclear chromatin, prominent nucleoli and
light blue cytoplasm. Two Polychromatic stage NRBCs. Acute Megakaryocytic Leukemia (M-7). Marrow - 100X
Слайд 66
Binucleated Plasma Cell, orthochromatic NRBC
One Binucleated Plasma Cell.
Compare its nuclear chromatin, which is typical for a
plasma cell, with that in previous image. A smudge nuclear mass and an orthochromatic NRBC are in the field. Normal marrow - 100X
Слайд 69
Megakaryoblast , fold in nucleus, normal marrow
One megakaryoblast
with an apparent fold in the nucleus. Normal marrow
- 100X
Слайд 70
Promegakaryocyte with nuclear separation, normal marrow
One promegakaryocyte with
nuclear separation and some nuclear lobulation. Normal marrow -
100X
Слайд 71
Abnormal megakaryocyte, Wright's-Giemsa stain, AML marrow
Mature Abnormal Megakaryocyte
with two apparent nuclei; one is very large. Wright's-Giemsa
stain. Acute Megakaryocytic Leukemia (M-7). Imprint of marrow biopsy - 100X
Слайд 72
Megakaryocyte and bare nuclei, megakaryocytic leukemia
Top left frame:
Small mature megakaryocyte with lobulated nuclei and scant cytoplasm.
Top right frame: Bare lobulated megakaryocyte nuclei. Lower left frame: Bare lobulated megakaryocyte nuclei. Lower right frame: Bare single megakaryocyte nucleus with a couple of cytoplasmic wisps still attached. Megakaryocytic leukemia (M-7) blood - 100X
