Microscopic Haematology: a Practical Guide for the Laboratory / Gillian Rozenberg
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Large Pink Inclusions in Multiple Myeloma Cells
Journal of Blood Disorders, Symptoms & Treatments Case Report Large Pink Inclusions in Multiple Myeloma Cells This article was published in the following Scient Open Access Journal: Journal of Blood Disorders, Symptoms & Treatments Received July 28, 2017; Accepted August 05, 2017; Published August 11, 2017 Juan Zhang1, Mingyong Li1*, Xianyong Jiang2 and Yuan He1 Abstract 1Clinical Laboratory of Sichuan Academy of Medical Objective: Several intracytoplasmic morphological changes in the plasma cells of Science & Sichuan Provincial People’s Hospital, multiple myeloma have been described previously, especially the Auer rod-like inclusions, Chengdu, Sichuan, China but large pink inclusions have not been reported yet. In this paper, we intend to report a rare 2 Haematology Bone Marrow Inspection laboratory case of inclusions in multiple myeloma. of Peking Union Medical College Hospital, Beijing, China Methods: Bone marrow aspiration from the right superior iliac spine was examined twice. Cells were stained with “Wright-Giemsa” method and also analyzed by flow cytometry, immunohistochemical staining and fluorescence in situ hybridization (FISH). Bone scan demonstrated bilateral ribs, thoracic vertebrae, with multiple low density shadows, which was confirmed subsequently as a lytic lesion on CT scanning. Complete blood count, serum chemistry and coagulation tests were also examined. Results: Bone marrow aspirate from the right superior iliac spine at the time of myeloma diagnosis showed about 58.5% of all nucleated cells being plasma cells, of which many had large pink intracytoplasmic inclusions. Repeat bone marrow biopsy later showed persistence of these morphological findings. All of Flow cytometry, immunohistochemistry and FISH examination support the diagnosis of multiple myeloma. Conclusion: This is the first time to report a multiple myeloma case with such giant pink inclusions. -
Clinically Pertinent Cytological Diff-Quick and Gram Stain
Clinically Pertinent Cytological Diff-Quick and Gram Stain Evaluation for the Reptilian Practitioner Kendal E Harr, DVM, MS, Dipl ACVP (Clinical Pathology), April Romagnano, PhD, DVM, DABVP (Avian) Session #214 Affiliation: URIKA, LLC, Mukilteo, WA 98275, USA (Harr), Avian and Exotic Clinic of Palm City, Palm City, Florida and the Animal Health Clinic, Jupiter, FL 33458, USA (Romagnano). Abstract: The goals of this work were to: 1) improve knowledge of preanalytic sampling techniques including blood smears, fine needle aspirates, imprints, smears, and fluid preparation including oral, dermal and cloacal swabs, cystic and solid mass sampling, joint fluids and effusions, and fecal smears and floats; and 2) enable the reptilian practitioner to better identify basic cells, classify disease processes, as well as infectious agents such as bacteria, fungi, and other structures. Discussion of diagnoses and treatment will follow. Generalized disease processes cross species and classes. The most important rule for cytologic interpretation is to not overinterpret the cytologic findings. Cytology helps guide therapeutic decision making by classification of disease process as neoplasia, fungal infection, etc but may not provide a definitive diagnosis. One should only interpret to the correct level of diagnosis and know when to refer the cytology and biopsy the lesion. Preanalytical Blood collection Collect less than < 1% of a reptile’s body weight. Use heparinized, size appropriate pediatric microtainers or Capijects®. Use the jugular vein in species where possible as the large bore vein decreases the likelihood of lymph dilution common in samples from the caudal vein. The right jugular may be larger in some species of lizard and tortoise but the size difference is not as dramatic as in avian species. -
Molecular Basis of Spectrin Deficiency in Beta Spectrin Durham. a Deletion
Molecular basis of spectrin deficiency in beta spectrin Durham. A deletion within beta spectrin adjacent to the ankyrin-binding site precludes spectrin attachment to the membrane in hereditary spherocytosis. H Hassoun, … , S S Chiou, J Palek J Clin Invest. 1995;96(6):2623-2629. https://doi.org/10.1172/JCI118327. Research Article We describe a spectrin variant characterized by a truncated beta chain and associated with hereditary spherocytosis. The clinical phenotype consists of a moderate hemolytic anemia with striking spherocytosis and mild spiculation of the red cells. We describe the biochemical characteristics of this truncated protein which constitutes only 10% of the total beta spectrin present on the membrane, resulting in spectrin deficiency. Analysis of reticulocyte cDNA revealed the deletion of exons 22 and 23. We show, using Southern blot analysis, that this truncation results from a 4.6-kb genomic deletion. To elucidate the basis for the decreased amount of the truncated protein on the membrane and the overall spectrin deficiency, we show that (a) the mutated gene is efficiently transcribed and its mRNA abundant in reticulocytes, (b) the mutant protein is normally synthesized in erythroid progenitor cells, (c) the stability of the mutant protein in the cytoplasm of erythroblasts parallels that of the normal beta spectrin, and (d) the abnormal protein is inefficiently incorporated into the membrane of erythroblasts. We conclude that the truncation within the beta spectrin leads to inefficient incorporation of the mutant protein into the skeleton despite its normal synthesis and stability. We postulate that this misincorporation results from conformational changes of the beta spectrin subunit affecting the binding of the abnormal heterodimer to ankyrin, and we provide evidence […] Find the latest version: https://jci.me/118327/pdf Molecular Basis of Spectrin Deficiency in p8 Spectrin Durham A Deletion within .3 Spectrin Adjacent to the Ankyrin-binding Site Precludes Spectrin Attachment to the Membrane in Hereditary Spherocytosis Hani Hassoun,* John N. -
Research Article
z Available online at http://www.journalcra.com INTERNATIONAL JOURNAL OF CURRENT RESEARCH International Journal of Current Research Vol. 8, Issue, 12, pp.42994-42999, December, 2016 ISSN: 0975-833X RESEARCH ARTICLE PLASMA CELLS IN HEALTH AND DISEASE *Karuna Kumari, Shwetha Nambiar, K., Vanishree C Haragannavar, Dominic Augustine, Sowmya, S. V. and Roopa S Rao Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka ARTICLE INFO ABSTRACT Article History: Plasma cells are the only cells that sustain antibody production and hence are an essential part of immune system. In the bone marrow plasma cells produce immunoglobulins which assure long-term Received 03rd September, 2016 Received in revised form humoral immune protection and in the mucosa-associated lymphoid tissues (MALT) plasma cells 16th October, 2016 secrete IgA which protect the individual from pathogens invasion. This review illustrates plasma cell Accepted 25th November, 2016 development and their role in both health and disease. Published online 30th December, 2016 Key words: Plasma cell, Immunoglobulin, B cells. Copyright©2016, Karuna Kumari et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Citation: Karuna Kumari, Shwetha Nambiar, K., Vanishree C Haragannavar, Dominic Augustine, Sowmya, S. V. and Roopa S Rao, 2016. “Plasma cells in health and disease”, International Journal of Current Research, 8, (12), 42994-42999. INTRODUCTION cytoplasm of the PCs contains large amount of rough endoplasmic reticulum (rER) and Golgi apparatus. The Plasma Cells (PCs) are non-dividing, effectors cells that cytoplasm of PC displays strong basophilia due to presence of represent the final stage of B cell differentiation. -
Erythrocytes: Overview, Morphology, Quantity by AH Rebar Et
In: A Guide to Hematology in Dogs and Cats, Rebar A.H., MacWilliams P.S., Feldman B.F., Metzger F.L., Pollock R.V.H. and Roche J. (Eds.). Publisher: Teton NewMedia, Jackson WY (www.veterinarywire.com). Internet Publisher: International Veterinary Information Service, Ithaca NY (www.ivis.org), 8-Feb-2005; A3304.0205 Erythrocytes: Overview, Morphology, Quantity A.H. Rebar1, P.S. MacWilliams2, B.F. Feldman 3, F.L. Metzger 4, R.V.H. Pollock 5 and J. Roche 6 1Dept of Veterinary Pathobiology, School of Veterinary Medicine, Purdue University, IN,USA. 2Dept of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin, WI, USA. 3Dept of Biomedical Sciences & Pathobiology, VA-MD - Regional College of Veterinary Medicine, Virginia Tech, VA, USA. 4Metzger Animal Hospital,State College,PA, USA. 5Fort Hill Company, Montchanin, DE, USA. 6 Hematology Systems, IDEXX Laboratories, Westbrook, ME, USA. Overview Production Red blood cells (RBC) are produced in the bone marrow. Numbers of circulating RBCs are affected by changes in plasma volume, rate of RBC destruction or loss, splenic contraction, erythropoietin (EPO) secretion, and the rate of bone marrow production. A normal PCV is maintained by an endocrine loop that involves generation and release of erythropoietin (EPO) from the kidney in response to renal hypoxia. Erythropoietin stimulates platelet production as well as red cell production. However, erythropoietin does not stimulate white blood cell (WBC) production. Erythropoiesis and RBC numbers are also affected by hormones from the adrenal cortex, thyroid, ovary, testis, and anterior pituitary. Destruction Red cells have a finite circulating lifespan. In dogs, the average normal red cell circulates approximately 100 days. -
Clinical Usefulness of Serum Procalcitonin Level in Distinguishing Between Kawasaki Disease and Other Infections in Febrile Children
Original article LeeKorean NY, Jet Pediatr al. • Serum 2017;60(4):112-117 procalcitonin level between Kawasaki disease and other infections https://doi.org/10.3345/kjp.2017.60.4.112 pISSN 1738-1061•eISSN 2092-7258 Korean J Pediatr Clinical usefulness of serum procalcitonin level in distinguishing between Kawasaki disease and other infections in febrile children Na Hyun Lee, MD1, Hee Joung Choi, MD1, Yeo Hyang Kim, MD2 1Department of Pediatrics, Keimyung University School of Medicine, Daegu, 2Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea Purpose: The aims of this study were to compare serum procalcitonin (PCT) levels between febrile Corresponding author: Yeo Hyang Kim, MD, PhD children with Kawasaki disease (KD) and those with bacterial or viral infections, and assess the clinical Department of Pediatrics, Kyungpook National Uni- versity School of Medicine, 680 Gukchaebosang-ro, usefulness of PCT level in predicting KD. Jung-gu, Daegu 41944, Korea Methods: Serum PCT levels were examined in febrile pediatric patients admitted between August 2013 Tel: +82-53-200-5720, and August 2014. The patients were divided into 3 groups as follows: 49 with KD, 111 with viral infec- Fax: +82-53-425-6683, tions, and 24 with bacterial infections. E-mail: [email protected] Results: The mean PCT level in the KD group was significantly lower than that in the bacterial infection Received: 26 August, 2016 group (0.82±1.73 ng/mL vs. 3.11±6.10 ng/mL, P=0.002) and insignificantly different from that in Revised: 27 October, 2016 the viral infection group (0.23±0.34 ng/mL,P=0.457). -
Hereditary Spherocytosis: Clinical Features
Title Overview: Hereditary Hematological Disorders of red cell shape. Disorders Red cell Enzyme disorders Disorders of Hemoglobin Inherited bleeding disorders- platelet disorders, coagulation factor Anthea Greenway MBBS FRACP FRCPA Visiting Associate deficiencies Division of Pediatric Hematology-Oncology Duke University Health Service Inherited Thrombophilia Hereditary Disorders of red cell Disorders of red cell shape (cytoskeleton): cytoskeleton: • Mutations of 5 proteins connect cytoskeleton of red cell to red cell membrane • Hereditary Spherocytosis- sphere – Spectrin (composed of alpha, beta heterodimers) –Ankyrin • Hereditary Elliptocytosis-ellipse, elongated forms – Pallidin (band 4.2) – Band 4.1 (protein 4.1) • Hereditary Pyropoikilocytosis-bizarre red cell forms – Band 3 protein (the anion exchanger, AE1) – RhAG (the Rh-associated glycoprotein) Normal red blood cell- discoid, with membrane flexibility Hereditary Spherocytosis: Clinical features: • Most common hereditary hemolytic disorder (red cell • Neonatal jaundice- severe (phototherapy), +/- anaemia membrane) • Hemolytic anemia- moderate in 60-75% cases • Mutations of one of 5 genes (chromosome 8) for • Severe hemolytic anaemia in 5% (AR, parents ASx) cytoskeletal proteins, overall effect is spectrin • fatigue, jaundice, dark urine deficiency, severity dependant on spectrin deficiency • SplenomegalSplenomegaly • 200-300:million births, most common in Northern • Chronic complications- growth impairment, gallstones European countries • Often follows clinical course of affected -
We Get Biased on Things That Make Sense
DIALOGUE AND DISCUSSION We Get Biased on Things That Make Sense MERIH T. TESFAZGHI When I was teaching third year medical students, and bench- reaction might be characterized by a marked left shift lecturing clinical laboratory science students, I emphasized which may display a range of immature cells that are also the importance of clinical details and the history of patients seen in CML. Severe left shift especially in the absence of in laboratory test processing, especially in the evaluation of evident infection (or other underlying diseases) may peripheral blood films. During those times, one of my strongly suggest direct bone marrow involvement. In students stated, “but including details of patients might such scenario, clinical details of patients such as absence somehow affect the decision of the reviewer, and may lead to or presence of enlargement of extramedullar organs is Downloaded from a bias.” I responded that we are biased on things that make highly sought. sense. This means that we decide based on the evidence we see from a microscopy evaluation in the light of the clinical Ø The coexistence of multiple conditions in a given detail and history. How do clinical details and history help us patient. One condition may mask the presence of the reach decisions? other condition. For example, the coexistence of megaloblastic anemia with iron deficiency anemia. http://hwmaint.clsjournal.ascls.org/ If specimens are the “in vitro ambassadors” of patients to the Usually, megaloblastic anemia is characterized by laboratory, then properly completed request forms are their increased size of red blood cells (MCV), but when “credentials”. -
Anormal Rbc in Peripheral Blood. [Repaired].Pdf
1. Acanthocyte 2. Burr-cell 3. Microcyte 1. Basophilic Normoblast 2. Polychromatic Normoblast 3. Pycnotic Normoblast 4. Plasmocyte 5. Eosinophil 6. Promyelocyte 1. Macrocyte 2. Elliptocyte 1. Microcyte 2. Normocyte 1. Polychromatic Erythrocyte 2. Acanthocyte 3. Elliptocyte 1. Polychromatic Normoblast 2. Pycnotic Normoblast 3. Neutrophil Myelocyte 4. Neutrophil Metamyelocyte 1. Schistocyte 2. Microcyte BASOPHILIC ( EARLY ) NORMOBLASTS Basophilic Erythroblast Basophilic Stippling, Blood smear, May-Giemsa stain, (×1000) CABOT'S RINGS Drepanocyte Elliptocyte Erythroblast ERYTHROBLAST in the blood Howell-jolly body Hypo chromic LACRYMOCYTES Leptocyte Malaria, Blood smear, May-Giemsa stain, ×1000 MICROCYTES Orthochromatic erythroblast Pappen heimer Bodies & 1. Schistocyte 2. Elliptocyte 3. Acanthocyte POIKILOCYTOSIS Polychromatic Erythroblast Pro Erytroblast Proerythroblasts Reticulocyte Rouleaux SICKLE CELLS Sickle cell Spherocyte Spherocyte Spherocyte SPHEROCYTES STOMATOCYTES Target Cells Tear Drop Cell, Blood smear, May-Giemsa stain, x1000 Anulocyte 1. Burr-cell 2. Elliptocyte 1. Macrocyte 2. Microcyte 3. Elliptocyte 4. Schistocyte 1. Ovalocyte 2. Lacrymocyte 3. Target cell 1. Polychromatic Erythrocyte 2. Basophilic Stippling 1. Proerythroblast 2. Basophilic Erythroblast 3. Intermediate Erythroblast 4. Late Erythroblast 5. Monocyte 6. Lymphocyte 1. Target-cell 2. Elliptocyte 3. Acanthocyte 4. Stomatocyte 5. Schistocyte 6. Polychromatophilic erythrocyte. 1.Pro erythroblast 2.Basophilic normoblast 3.Polychromatic normoblast 4.Pycnotic normoblast -
Wright's Stain
WRIGHT’S STAIN - For in vitro use only - Catalogue No. SW80 Our Wright’s Stain can be used to stain blood Interpretation of Results smears in the detection of blood parasites. Wright’s Stain is named for James Homer If malaria parasites are present, the Wright, who devised the stain in 1902 based on a cytoplasm stains pale blue and the nuclear modification of the Romanowsky stain. The stain material stains red. Schüffner’s dots and other distinguishes easily between blood cells and RBC inclusions usually do not stain or stain became widely used for performing differential very pale with Wright’s stain. Nuclear and white blood cell counts, which are routinely cytoplasmic colors that are seen in the malarial ordered when infections are expected. The stain parasites will also be seen in the trypanosomes contains a fixative, methanol, and the stain in one and any intracellular leishmaniae that are solution. Thin films of blood are fixed with present. methanol to preserve the red cell morphology so Refer to an appropriate text for a detailed that the relationship between parasites to the red description of characteristic morphological cells can be seen clearly. structures of different parasitic organisms and human cell types. Formula per Litre • Make sure all slides are clean prior to Wright’s Stain .............................................. 1.8 g making the blood smear to ensure that the Methanol .................................................. 1000 mL stain absorbs properly • Tap water is unacceptable for the rinsing Recommended Procedure solution as the chlorine may bleach the stain 1. Dip slide for a few seconds in methanol as a fixative step and allow slide to air dry • Finding no parasites in one set of blood completely. -
The Hematological Complications of Alcoholism
The Hematological Complications of Alcoholism HAROLD S. BALLARD, M.D. Alcohol has numerous adverse effects on the various types of blood cells and their functions. For example, heavy alcohol consumption can cause generalized suppression of blood cell production and the production of structurally abnormal blood cell precursors that cannot mature into functional cells. Alcoholics frequently have defective red blood cells that are destroyed prematurely, possibly resulting in anemia. Alcohol also interferes with the production and function of white blood cells, especially those that defend the body against invading bacteria. Consequently, alcoholics frequently suffer from bacterial infections. Finally, alcohol adversely affects the platelets and other components of the blood-clotting system. Heavy alcohol consumption thus may increase the drinker’s risk of suffering a stroke. KEY WORDS: adverse drug effect; AODE (alcohol and other drug effects); blood function; cell growth and differentiation; erythrocytes; leukocytes; platelets; plasma proteins; bone marrow; anemia; blood coagulation; thrombocytopenia; fibrinolysis; macrophage; monocyte; stroke; bacterial disease; literature review eople who abuse alcohol1 are at both direct and indirect. The direct in the number and function of WBC’s risk for numerous alcohol-related consequences of excessive alcohol increases the drinker’s risk of serious Pmedical complications, includ- consumption include toxic effects on infection, and impaired platelet produc- ing those affecting the blood (i.e., the the bone marrow; the blood cell pre- tion and function interfere with blood cursors; and the mature red blood blood cells as well as proteins present clotting, leading to symptoms ranging in the blood plasma) and the bone cells (RBC’s), white blood cells from a simple nosebleed to bleeding in marrow, where the blood cells are (WBC’s), and platelets. -
Appendix A: Standardization of Staining Methods
Appendix A: Standardization of Staining Methods H. Lyon, D. Wittekind, E. Schulte No detailed descriptions of staining methods are provided in this book. The reader is referred to one or more of the excellent texts covering this field (cf. Preface). Nevertheless, we have feIt it appropriate to inc1ude this appendix which gives some of our views on the technical aspects of procedures which should be given particular emphasis. It is our opinion that the need for standardization and quan titative methods in daily work is pressing. This appendix sets out the appropriate general considerations followed by a few selected methods in order to cover this area. A.l General Considerations According to Boon and Wittekind (1986) the principle aim of standardizing staining methods is to render their application reproducible and therefore reliable. This is of the utmost importance when dyes and stains are used for automated cell pattern recognition (Wittekind, 1985; Wittekind and Schulte, 1987). The theoretical background for standardization of cell and tissue preparation sterns from the fact that any preparatory step - from cell sampling to mounting of the stained slide - will somehow affect the structure of the cell and ultimately lead to the production of a particular staining pattern which, in strict tenns, is an artifact. What we eventually observe by microscopy is, from the perspective of a cell, the product of a rather violent procedure: In cytological preparations the cells have been isolated from their tissue, spread out on the surface of a glass slide and immersed in a liquid poison which abruptly arrests and - sensu stricto - "fixes" the cell in the very last moment of its life.