EOSINÓFILO - Amazon Web Servicesecaths1.s3.amazonaws.com/hematologiaclinicafacena/1242002997... ·...
Transcript of EOSINÓFILO - Amazon Web Servicesecaths1.s3.amazonaws.com/hematologiaclinicafacena/1242002997... ·...
EOSINÓFILOS*Tamaño: 14 a 16 um*GRANULOS:*Los gránulos tienen una membrana y un núcleo cristaloide, formado por un centro denso que consiste en un polímero de Proteína Básica Principal (PBP).Tóxica para esquistosoma, trichinellas, cél tumorales y causa injuria en el asma
*Matriz granular: menos compacta.-Tiene la Proteína Catiónica de los Eosinofilos:
alto contenido en arginina y Zn, No tiene actividad bactericida ,pero es una toxina potente para el esquistosoma
-Neurotoxina Derivada de Eosinófilos(NDE)Neurotóxica podría explicar las alteraciones neurológicas que tienen algunos pacientes con hipereosinofilia en el LCR
*Matriz granular:-Peroxidasa de Eo ;resistente al KCN-Colagenasa-Fosfolipasa B yD :anula los fact activ plaq-Beta glucuronidasa-Ribonucleasa-Catepsina-Catalasa-Histaminasa-No poseen FAL ni lisozima
*Otros Gránulos pequeños:Podrían ser de naturaleza lisosómica-Aril sulfatasa: inactiva los péptidos
quimiotácticos-Fosfatasa Acida-Leucotrienos, PAF
*Citoquímica: Glucógeno (+) en el citoplasmaPeroxidasa(+) Sudan(+)
1. polychromatic normoblast 2. pycnotic normoblast 3. band neutrophil 4. neutrophil myelocyte 5. neutrophil metamyelocyte
Magnification: x 1000
Staining: MGGComment: Mature eosinophil leucocyte with bi-lobulated nucleus and typical eosinophil granularity.
Occurrence:blood: 2 - 4 %marrow: < 2 %
Nucleoli: not visible
Nuclear/cytoplasmic ratio: low or very low
Type of chromatin: condensed
Nucleus' shape: lobulated, semicircular
Granularity: abundant eosinophilic (orange-red)
Colour of cytoplasm: pale, covered by granules
Shape of the cell: oval or round
Size of the cell: 15 - 25 m
Magnification: x 1000
Staining: MGGComment: Single eosinophil leucocyte with bi-lobulated nucleus. Also anisocytosis of erythrocytes and ovalocytes. Normal platelets.
Occurrence:blood: 2 - 4 %marrow: < 2 %
Nucleoli: not visible
Nuclear/cytoplasmic ratio: low or very low
Type of chromatin: condensed
Nucleus' shape: lobulated, semicircular
Granularity: abundant eosinophilic (orange-red)
Colour of cytoplasm: pale, covered by granules
Shape of the cell: oval or round
Size of the cell: 15 - 25 m
BASOFILOS*Tamaño:10um .Gránulos metacromáticos por la
presencia de glucosaminoglicanos, el núcleo es irregularmente lobulado. Poseen receptores para IgE
*GRANULOS: Son gránulos 1º-Peroxidasa-Histamina-Mucoplisacaridos àcidos Heparina-PAF: Activador de la agregación plaquetaria y
liberador de serotonina
Magnification: x 1000
Staining: MGGComment: Single basophil leucocyte. Also three schistocytes.
Occurrence:blood: < 1 %marrow: < 1 %
Nucleoli: not visible
Nuclear/cytoplasmic ratio: low or very low
Type of chromatin: condensed, pale
Nucleus' shape: oval shaped in not mature forms; lobular shaped in mature forms
Granularity: very dark, basophilic, granules of various size. The amount varies
Colour of cytoplasm: light-pink, mostly covered by granules and nucleus
Shape of the cell: round or oval
Size of the cell: 12 - 18 m
BASOFILO
MONOCITOS
15 A 25 mGRANULACION AUSENTE O MUY
ESCASA CITOPLASMA CON
GRANULACIÓN MUY FINA CROMATINA GLOBOSA
SISTEMA MONONUCLEAR FAGOCITICO
*MONOCITOS*MACROFAGOS-Histiocitos( tejido conectivo)-Macrófagos,alveolares,peritoneales,MO-Celulas Dendríticas-Células de Kupffer-Osteoclasto (hueso)Celulas de Langerhans (piel)
MONOBLASTO
1. myeloblast 2. promyelocyte 3. neutrophil myelocyte 4. proerythroblast 5. pycnotic normoblast 6. polychromatic normoblast7. band neutrophil
Magnification: x 1000
Staining: MGGComment: In the picture a monoblast is depicted. Also numerous other maturating cells of granulopiesis are present.
Occurrence:blood: not presentmarrow: < 1 %
Nucleoli: visible, medium or large size, brighter than chromatin, 1 to 3.
Nuclear/cytoplasmic ratio: high
Type of chromatin: coarse chromatin or clumped
Nucleus' shape: oval, round, sometimes irregular
Granularity: without granules or a few, azurophilic, fine granules
Colour of cytoplasm: blue, usually light
Shape of the cell: oval, sometimes round
Size of the cell: 15 - 25 m
PROMONOCITO
1. myeloblast 2. lymphocyte 3. proerythroblast 4. basophilic normoblast 5. polychromatic normoblast 6. pycnotic normoblast7. neutrophil myelocyte 8. neutrophil metamyelocyte 9. band neutrophil
Magnification: x 1000
Staining: MGGComment: The arrow indicates a promonocyte with distinct nucleolus.
Occurrence:blood: not presentmarrow: < 1 %
Nucleoli: hardly visible, medium or large size; brighter than chromatin, 1 to 3.
Nuclear/cytoplasmic ratio: moderate
Type of chromatin: coarse chromatin or clumped
Nucleus' shape: usually irregular
Granularity: without granules or a few, azurophilic, fine granules
Colour of cytoplasm: light, grey-blue
Shape of the cell: oval, sometimes round
Size of the cell: 15 - 25 m
PROMONOCITO
1. promyelocyte 2. neutrophil myelocyte 3. neutrophil metamyelocyte 4. band neutrophil 5. eosinophil 6. lymphocyte 7. pycnotic normoblast 8. polychromatic normoblast
Magnification: x 1000
Staining: MGGComment: Promonocyte in bone marrow. Also numerous other maturating cells of granulopiesis and erythroblasts are present.
Occurrence:blood: not presentmarrow: < 1 %
Nucleoli: hardly visible, medium or large size; brighter than chromatin, 1 to 3.
Nuclear/cytoplasmic ratio: moderate
Type of chromatin: coarse chromatin or clumped
Nucleus' shape: usually irregular
Granularity: without granules or a few, azurophilic, fine granules
Colour of cytoplasm: light, grey-blue
Shape of the cell: oval, sometimes round
Size of the cell: 15 - 25 m
1. promyelocyte 2. neutrophil myelocyte 3. neutrophil metamyelocyte 4. band neutrophil 5. segmented neutrophil6. pycnotic normoblast 7. polychromatic normoblast 8. basophilic normoblast 9. lymphocyte 10. eosinophil
Magnification: x 1000
Staining: MGGComment: The arrow indicates a monocyte. Also numerous cells of the granulocytic series at different stages of maturation.
Occurrence:blood: 4 - 8 %marrow: < 2 %
Nucleoli: not visible
Nuclear/cytoplasmic ratio: moderate or low
Type of chromatin: coarse chromatin, clumped
Nucleus' shape: usually irregular
Granularity: absent or a few, azurophilic, very fine granules
Colour of cytoplasm: grey-blue
Shape of the cell: round, oval or irregular
Size of the cell: 15 - 25 m
MONOCITO
Magnification: x 1000
Staining: MGGComment: Typical monocyte with abundant purple-blue cytoplasm containing small vacuoles.
Occurrence:blood: 4 - 8 %marrow: < 2 %
Nucleoli: not visible
Nuclear/cytoplasmic ratio: moderate or low
Type of chromatin: coarse chromatin, clumped
Nucleus' shape: usually irregular
Granularity: absent or a few, azurophilic, very fine granules
Colour of cytoplasm: grey-blue
Shape of the cell: round, oval or irregular
Size of the cell: 15 - 25 m
MONOCITO
Magnification: x 1000
Staining: MGGComment: Monocyte with moderate nucleus-cytoplasmic ratio, intense basophilic staining cytoplasm in some spots and marbled structure of cytoplasm. Numerous platelets with normal granulation.
Occurrence:blood: 4 - 8 %marrow: < 2 %
Nucleoli: not visible
Nuclear/cytoplasmic ratio: moderate or low
Type of chromatin: coarse chromatin, clumped
Nucleus' shape: usually irregular
Granularity: absent or a few, azurophilic, very fine granules
Colour of cytoplasm: grey-blue
Shape of the cell: round, oval or irregular
Size of the cell: 15 - 25 m
MONOCITO
LINFOCITOS
10 a 15 µm Citoplasma celeste claro No posee gránulos visibles Núcleo con cromatina condensada generalmente excéntrico
Magnification: x 1000
Staining: MGGComment: The cell indicated by the arrow is a precursor cell of lymphocytes, photographed within a lymph nodule of the bone marrow. Almost all the surrounding cells belong to the lymphopoiesis.
Occurrence in blood: not present marrow: < 1 %
Nucleoli: visible, small or medium size, brighter than chromatin, 1 to 2.
Nuclear/cytoplasmic ratio: high
Type of chromatin: homogenous
Nucleus' shape: round
Granularity: not present
Colour of cytoplasm: blue, usually dark
Shape of the cell: round, sometimes oval
Size of the cell: 12 - 18 m
Linfoblastos
1. lymphocyte 2. promyelocyte 3. monocyte 4. polychromatic normoblast 5. pycnotic normoblast 6. plasmocyte 7. neutrophil metamyelocyte 8. neutrophil myelocyte
Magnification: x 1000
Staining: MGGComment: The indicated lymphocyte is one of three present in the picture.
Occurrence:blood: 25 - 40 %marrow: 5 - 20 %
Nucleoli: invisible, sometimes hardly visible, small, single nucleous
Nuclear/cytoplasmic ratio: high or very high
Type of chromatin: homogenous, condensed
Nucleus' shape: round or slightly oval
Granularity: not present
Colour of cytoplasm: blue
Shape of the cell: round, sometimes oval
Size of the cell: 10 - 15 m
LINFOCITO
Magnification: x 1000
Staining: MGGComment: Typical small lymphocyte in blood. Also a single schistocyte.
Occurrence:blood: 25 - 40 %marrow: 5 - 20 %
Nucleoli: invisible, sometimes hardly visible, small, single nucleous
Nuclear/cytoplasmic ratio: high or very high
Type of chromatin: homogenous, condensed
Nucleus' shape: round or slightly oval
Granularity: not present
Colour of cytoplasm: blue
Shape of the cell: round, sometimes oval
Size of the cell: 10 - 15 m
LINFOCITO
Magnification: x 1000
Staining: MGGComment: Large granular lymphocyte with typical for the series coarse, azurophilic granularity and clear cytoplasm. Some stomatocytes are also present.
Occurrence blood: < 10 %
Nucleoli: not visible
Nuclear/cytoplasmic ratio: moderate or low
Type of chromatin: fine, homogenous
Nucleus' shape: oval, irregular
Granularity: a few, thick azurophilic granules
Colour of cytoplasm: blue
Shape of the cell: irregular
Size of the cell: 15 - 25 m
LINFOCITO GRANDE GRANULAR
Magnification: x 1000
Staining: MGGComment: Lymphoplasmocyte often has irregular shape of the nucleus, dark marbled chromatin and very strong basophilic staining of the cytoplasm. Platelets are normal.
Occurrence blood: < 2 %
Nucleoli: invisible or hardly visible, single
Nuclear/cytoplasmic ratio: moderate or low
Type of chromatin: clumped
Nucleus' shape: oval or irregular
Granularity: none
Colour of cytoplasm: deep blue
Shape of the cell: oval
Size of the cell: 10 - 20 m
LINFOPLASMOCITO
Magnification: x 1000
Staining: MGGComment: Lymphoplasmocyte is an activated B-cell lymphocyte. The morphology of the cell is between lymphocyte and plasma cell (increased volume of cytoplasm, the beginning of appearance of perinuclear halo, strong basophilic staining cytoplasm). Chromatin is not yet typical for plasma cell.
Occurrence blood: < 2 %
Nucleoli: invisible or hardly visible, single
Nuclear/cytoplasmic ratio: moderate or low
Type of chromatin: clumped
Nucleus' shape: oval or irregular
Granularity: none
Colour of cytoplasm: deep blue
Shape of the cell: oval
Size of the cell: 10 - 20 m
LINFOPLASMOCITO
PLASMOCITO O CELULA PLASMÁTICA
1. eosinophil 2. neutrophil myelocyte 3. promyelocyte 4. neutrophil metamyelocyte 5. myeloblast 6. polychromatic normoblast
Magnification: x 1000
Staining: MGGComment: The arrow indicates a single plasma cell. Besides, most of the cells belong to granulopoiesis.
Occurrence:blood: not presentmarrow: < 3%
Nucleoli: not visible
Nuclear/cytoplasmic ratio: low
Type of chromatin: condensed
Nucleus' shape: round
Granularity: none
Colour of cytoplasm: deep-blue with big perinuclear halo, sometimes single vacuole is present
Shape of the cell: oval
Size of the cell: 15 - 20 m
1. neutrophil myelocyte 2. neutrophil metamyelocyte 3. band neutrophil 4. lymphocyte 5. promyelocyte 6. proerythroblast 7. eosinophil
Magnification: x 1000
Staining: MGGComment: The arrow indicates a single plasma cell. Besides, most of the cells belong to granulopoiesis.
Occurrence:blood: not presentmarrow: < 3%
Nucleoli: not visible
Nuclear/cytoplasmic ratio: low
Type of chromatin: condensed
Nucleus' shape: round
Granularity: none
Colour of cytoplasm: deep-blue with big perinuclear halo, sometimes single vacuole is present
Shape of the cell: oval
Size of the cell: 15 - 20 m
PLASMOCITO O CELULA PLASMÁTICA
Magnification: x 1000
Staining: MGGComment: Plasma cell in blood with typical perinuclear halo, which is a sign of cell maturation. Also a neutrophilmetamyelocyte is present. Erythrocytes are not suitable for making an assessment.
Occurrence:blood: not presentmarrow: < 3%
Nucleoli: not visible
Nuclear/cytoplasmic ratio: low
Type of chromatin: condensed
Nucleus' shape: round
Granularity: none
Colour of cytoplasm: deep-blue with big perinuclear halo, sometimes single vacuole is present
Shape of the cell: oval
Size of the cell: 15 - 20 m
PLASMOCITOS
LEUCOPENIA< 3000 GB mm3
CONGÉNITA (KOSTMANN) POR FÁRMACOS ALTERACIONES DE ERITROPOYESIS SESPSIS MALIGNAS RADIOTERAPIA QUIMIOTERAPIA
LEUCOCITOSIS: NEUTROFILIA> 7500/mm3
Fisiológicas: ejercicio, tabaquismo, pospandrial, frío , calor, traumas, náuseas, vómitos, stress psicológico.
Síndrome mieloproliferativo. Inflamación/necrosis: infarto, colagenosis,
neoplasias. Fármacos: corticoides, antiepilépticos. Metabólicas: acidosis, eclampsia. Hemólisis, hemorragia, hipoxia. DBT
Leucocitosis eosinofílica>400/ mm3
Desórdenes alérgicos. Parasitosis. Infecciones agudas: escarlatina, colagenopatías. Afecciones cutáneas: psoriasis, eczemas,
dermatitis. Anomalías hereditarias. Desórdenes GI.
Leucocitosis basofílica
> 100/ mm3 Reacciones de hipersensibilidad Urticaria pigmentosa Colitis ulcerosa Anemia hemolítica Radiaciones LMC Sind. mieloproliferativos
Leucocitosis: monocitosis> 800/mm3
Sind. Mieloproliferativos Mielodisplasias Leucemia aguda Infecciones bacterianas: rickettsias, protozoarios. Colagenosis. Digestivas: colitis ulcerosas Lupus , artritis reumatoidea. Convalescencia de infecciones.
REACCION LEUCEMOIDE > 50.000 GB ASOCIADA A PROCESOS INFECCIOSOS (TBC,
CLOSTRIDIUM), DROGAS (CORTICOIDES, MINOCICLINA), PROCESOS TUMORALES (CSF-GM, IL 3Y6)
EN MO HIPERPLASIA MIELOIDE NORMAL DESVIACIÓN A LA IZQUIERDA DE NATURALEZA POLICLONAL PUEDE AFECTAR GRANULOCITOS, LINFO Y
MONOCITOS SCORE DE FAL-L AUMENTADO DIAG DIFERENCIAL DE LMC Y LNC
35
37
38
36
40
41
39
7 8 9 10 11 12 13654321
25
20
20
15
10
5
25
30
40
80
70
60
50
40
30
20
10
T°
Nø
LYN
MON-EOS %/ GB mm3