38_Blood Cell & Urine Sediment Desktop Reference

7/31/2019 38_Blood Cell & Urine Sediment Desktop Reference

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DESKTOP READY RECKONER FOR THE PRACTICING

PAEDIATRICIAN TO IDENTIFY CERTAIN BASIC CELLS IN A

PERIPHERAL SMEAR & URINE SEDIMENTS

Prepared by

Dr.S.R.Srinivasa Kannan,MD.Path,

Vivek Laboratories, 253,K-11,K.P.Road,Nagercoil-3. 629003 .

e mail: [email protected]



• This is not an exhaustive reference.

• This is only a short introduction to the

exciting field of Clinical Microscopy



Note

• Areas for morphological assessment should be largeenough that at least 100 WBCs can be identified insamples with a WBC count within the reference intervalfor a specific individual.

• In a wedge blood film preparation, the best area is wherered blood cells barely touch each other.

• Cells should not be damaged by the preparation or staining procedure or by excessive shear forces for microscopy

• In a large blood film preparations; large cells such asmonocytes may be pushed to the periphery and thefeathered edge of the blood film.



Good & Bad smear

Smooth & Uniform

staining

Irregular smear, Oil

droplets



Examine

RBCs: Where cells

are just touching each

other

WBCs: in zig zag fashion

Platelets:

Examine the whole smear



Normocytic Normochromic:

Equal in size to the nucleus of lymphocytes or slightly larger with smallcentral pale area



Macrocytic: Larger than the normoytes. Always normochromic



• Microcyte: Smaller than the nucleus of the small lymphocyte.

• Always hypochromic-marked central pallor



Spherocytes:Small cells with no central pallor



Elliptocyte/Ovalocyte : Abnormal congenital oval forms



Stomatocytes : Abnormal congenital forms with a central mouth like slit.



• Target Cells: Seen in Liver disorders and thalassemias



Sickle cells: Sickling at hypoxic conditions. HbS. Drying of slide can pull the plasma and produce sickle shaped artifacts which is of variable size and the pulling effect will be obviousby the clearing in the surrounding areas



• Acanthocyte: Irregular cytoplasmicspicules of variable length

• Irregularly disposed over the surface.(red cell Membrane abnormality

• Echinocyte: Many short regular

projections. Usually EDTA effect.



MP: P.falciparum

• Basophilic stipplings: Numerous basophilic granules.

Occurs in Thalassemias, lead

poisoning & liver disease

Platelet Mimicking MP



Water Artifact: Cells swollen and partly dehemoglobinised



Reticulocytes:

seen with New methylene blue

Normoblasts: Normoblasts-Mimics lymphocytes.Note abundance of cytoplasm, irregular borders,

Centrally placed nuclei



Platelets: Found as clumps and as singleplatelets

Stain particles: Mimics platelets.

Bluish in color

P l h T t l b C t l h hili ( )



Polymorph: Two to many lobes. Cytoplasm shows azurophilic (grey)

Granules.

Hypersegmented Neutrophils:

Seen in Megaloblastic Anemia

Toxic granules: Seen in Septicaemia

Eosinophil has

eosin granules



Monocytes

Eosinophil

Basophil

Polymorph



• Myelocyte:

Mimicking monocyte.Bean shaped nucleus

and

• granules in cytoplasm



• Promyelocyte:

Comparable to

myelocyte but in

addition has nucleoli.



• Myeloblast : Similar topromyelocyte but withoutgranules. Cytoplasm

• May show eosin colouredshort rods-Auer rods .

Nucleoli>4



Lymphoblast: Large cell. Cytoplasm is scanty. 1-2 nucleoli. No

granules



Storage artifacts:

WBCs show fragmentation of nuclei and can mimic normoblats.



• Urine Sediments

iQ®200 Automated Urine Microscopy Analyzer



Hyaline cast

Smooth

borders,almost

transparent



Cellular cast + yeast cells

Degenerated cellular cast is

granular cast

Border not regular. Cells

and fragments seen



Refractile bodies with cut

edges



Ca oxalate



Triple phosphate

tyrosine



cystine

cholesterol

Uric acid

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• Each soul is potentially divine.

• The goal is to manifest this divinity within by

controlling nature,external and internal .

• Do this either by work,or worship, or psychic control, or philosophy:by one, or more, or all of these — and be free.

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38_Blood Cell & Urine Sediment Desktop Reference

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