Question

For these different white cell abnormalities - Tell me about them on a microscopic level - as we would see them on a slide :

For each tell me , the observation - how it looks , color of cyoplasm , is it granulated etc.

AND the abnormality - how is it abnormal ? its larger, different color etc.

Acute Lymphocytic Leukemia

Acute Monocytic Leukemia

Acute Granulated Leukemia

Chronic Lymphocytic Leukemia

Infectious Mono

Multiple myeloma

Myeloid leukemia

Answer 1

There are five types of white blood cells. They are neutrophils, eosinophils, basophils, lymphocytes, and monocytes. These five types are in two main groups: The Granulocytes and The Non-granulocytes

Neutrophills:-
The neutrophils make up the majority of the total white blood cells in a normal person's blood. Of the total white blood cells, there are usually 50-70 percent neutrophils. A mature neutrophil has a segmented nucleus and is twice the size of a red blood cell. A segmented nucleus means that you can see two to five segments (aka- lobes) of nucleus in one cell.

Eosinophils:-
are also granulocytes...so they have granules, too! Their granules are different from neutrophil granules, though. The suffix "phil" means "to love". Eosin is a type of acid red dye. Therefore, eosinophils love eosin dye. They grab onto lots of eosin dye when they're stained, making their large granules a red color. The granules in an eosinophil usually cover the nucleus, but sometimes you can see that the nucleus is segmented. Eosinophils are not as common in the blood as neutrophils. They're usually less than three percent of a person's total white blood cells. Unless you have allergies.....then they come out to fight! Depending on the severity of the allergic reaction, they can be in much higher percentages. Although their primary job is to be involved in allergic reactions, eosinophils are also increased when a person has a parasite. For example, a person with a tapeworm in their digestive tract will have an elevated eosinophil count.
Basophils:-
Basophils, the last and least (in number) of the granulocytes. They are present as one percent or less of a person's white blood cells. Just like the eosinophils, basophils love dye. But, basophils love "basic blue" dye. Therefore, their large granules are a deep blue-purple color. Their nucleus is also segmented, but it's hard to see in the presence of those intense granules!
Lymphocytes:-
The lymphocytes and monocytes belong to the mononuclear cell group. This means their nucleus is in one piece. Lymphocytes are the main cells in the lymph nodes. There are almost as many lymphocytes as neutrophils in the blood. Lymphocytes are special because they can become "memory cells". When doctors talk about a person being "immune", they are referring to the ability of that person's lymphocytes to remember a foreign invader. When a person is exposed to a new infectious agent, some of their lymphocytes make antibodies against it. The rest of the lymphocytes remember that infectious agent and get the immune system working faster the next time a person is exposed to that infectious agent. Very young children have more lymphocytes than adults because they are developing immunity to the many new infectious agents around them. Lymphocytes make up 20-40 percent of an adult's total white blood cells.

Small lymphocytes have a round nucleus and a small amount of blue cytoplasm. Overall, the lymphocyte looks very smooth and round. Lymphocytes vary a lot. They can be larger with a lot of cytoplasm when they are encountering an infectious agent. Sometimes they can even look wavy, like a potato chip!
Monocytes:-
Monocytes are large cells- three to four times the size of a red blood cell! However, there are not too many in the bloodstream. In a normal person, there are one to six percent monocytes. Monocytes can be difficult to differentiate from lymphocytes. Monocytes usually have a larger amount of cytoplasm in relation to the size of the nucleus. They are also usually more irregular in shape than the smooth lymphocytes. You can sometimes see "pseudopods" on monocytes, the "fake feet" that help it move and digest foreign particles. The cytoplasm of a monocyte is a dull blue-gray color. Even though they are not granulocytes, monocytes have granules! They are very fine and lightly stained, giving the monocyte cytoplasm a "ground-glass" appearance. You may also see vacuoles. These look like holes in the cytoplasm. When a monocyte has vacuoles, you know it has been hard at work. The vacuoles contain chemicals that digest the foreign particles. The nucleus of the monocyte is usually kidney-shaped and has brain-like convolutions (ie- the nucl

Abnormalities of WBCs:-

Dohle Bodies

Dohle Bodies are rough endoplasmic reticulum remnants of RNA. They are found in neutrophils and seen in conditions such as bacterial infections, burns, poisoning, and cytotoxic drugs such chemotherapy, May-Hegglin Anomaly, or pregnancy

May Hegglin Anomaly

May-Hegglin Anomaly is associated with thrombocytopenia and giant platelets. It also has large inclusions that resemble Dohle bodies in all the leukocytes. There is no toxic granulation.

Toxic Granulation (Hypergranulation)

Toxic granulation is characterized by the presence of few to many prominent primary blue-black granules in the cytoplasm of neutrophils, and they're unevenly distributed. This is associated with:

bacterial infection
burns
poisoning
chemotherapy
pregnancy

Hypogranulation or Degranulation:

Hypogranulation, or degranulation, is characterized by a decrease in number or complete absence of specific granules. This means either an infection is present, or the possibility of myelodysplastic syndrome.

Pelger Huet Anomaly (Pelgeroid Cells)/Hyposegmentation: <3 lobed neutrophil

Pelger Huet cells have a bilobed or peanut-shaped nucleus in neutrophils. Associated with:

Pelger Huet Anomaly
Myeloproliferative or myelodysplastic disorders

Hypersegmentation: >5 lobed neutrophil

These are neutrophils with 6+ nuclear lobes. These are associated with:

Megaloblastic anemias (Vitamin B12 or folate deficiency)
Chronic infections
Rarely inherited

Sezary Cells

Sezary cells are neoplastic CD4+ T-lymphocytes. They are abnormal and have a convoluted, twisted nucleus sometimes resembling a clover.   Sezary disease or syndrome consists of abnormal T-cells that result in cutaneous lymphomas of the skin and microabscesses, erythroderma and hepatosplenomegaly, along with Sezary cells seen in the peripheral blood smear. These T-cells have an overabundance of mucopolysaccharides. Mycosis fungoides with lymphadenopathy may result in Sezary disease at the end stages. Sezary disease is very rare.

Auer Rods

Auer Rods are elongated clumps of granular material (fused lysosomes and neutrophilic granules) azuric in color that are seen in the cytoplasm of leukemic blasts in Acute Myelogenous Leukemia (AML) and Acute Promyelocytic Leukemia, or AML M2 and M3. They are also seen in the myelodysplastic syndromes and myeloproliferative disorders. Auer rods are shaped like needles and may or may not be pointed at the ends.

eus looks like it's folded).

Acute myeloid leukemia-Acute lymphocytic leukemia:-
A type of cancer of the blood and bone marrow that affects white blood cells.
Chronic lymphocytic leukemia:-same as ALL but it is slow progressing.
Acute monocytic leukemia:-