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Introduction
In this Lab Session we will use both images from light microscopic slides and Anderson’s Electronic Atlas of
Hematology to study blood cells and blood cell development.
As you work through Objectives 1.1, 1.2 and 1.3, use the following decision chart to help you identify cells and
cell fragments found in the peripheral blood.
NUCLEUS PRESENT
Granular
NO CYTOPLASMIC GRANULES (Plate 18, top and middle, pp. 308-309)
cytoplasm?
? ▪ Lymphocyte (6-12m) nuclei are round with darkly stained, condensed
chromatin. There is usually only a thin rim of basophilic cytoplasm visible,
with no granules. T lymphocytes cannot be distinguished from B lymphocytes
with routine staining. Differentiation between these cells can be done with
special stains which include antibodies to specific T and B cell membrane
markers.
▪ Monocytes (9-18m) are the largest of the circulating blood cells. The
monocyte nucleus is indented, horseshoe-shaped or peanut-shaped, but is not
multilobed. The monocyte nucleus is eccentric within the cell, not as
heterochromatic as the lymphocyte nucleus, and may have several nucleoli.
Monocytes have much more cytoplasm than do lymphocytes. The cytoplasm of
monocytes is slightly basophilic. It contains some magenta granules
(lysosomes), but these are not as prominent as those seen in granulocytes.
(Remember, the monocyte does not belong to the granulocytic series).
The stages of blood cell development will be studied using the examples in Anderson’s Electronic Atlas of
Hematology. This atlas includes many examples of both normal and abnormal blood cell development; however,
this Lab Session will focus primarily on the normal developmental sequences. You will see some abnormal blood
smears when you work through the questions at the end of this Lab Session.
As you work through Objectives 3 and 4, use the following decision chart to help you identify the stages of
erythropoiesis (erythrocyte development) and granulopoiesis (granulocyte development).
Granular
NO CYTOPLASMIC GRANULES : erythropoietic cells
cytoplasm?
(Fig. 10.22, pg. 296)
▪ If, in a bone marrow preparation, you find a cell that does not have cytoplasmic
granulation, it is most likely part of the erythropoietic series. The development
of erythrocytes is characterized by the following changes:
o Cell size decreases
o Nucleus and its chromatin gradually condense, until finally the nucleus is
extruded. The nucleus remains round, and is usually near the center of
the cell until the last stage of development.
o Cytoplasmic staining goes through the following changes:
1) Basophilic due to ribosomes used in hemoglobin synthesis; then →
2) Mixed basophilic/eosinophilic as hemoglobin is produced; finally →
3) Eosinophilic, since ribosomes are lost once hemoglobin content is
sufficient.
Note: Basophils follow the same developmental path as do the other granulocytes. However, because their
numbers are so low, they are difficult to find in bone marrow and peripheral blood specimens. It is for this
reason that we do not ask you to identify basophils and their precursors in sections or smears during this Lab
Session. We have, however, included images of basophils. You will also see examples of basophils in
Integrative Question 4.
Objective 1: In Objectives 1.1, 1.2 and 1.3, you will examine the cells of peripheral blood. As you
examine the following cells, note the differences in cell size, nucleus size and shape and
cytoplasmic staining and presence of absence of cytoplasmic granules:
▪ Erythrocyte
▪ Neutrophil
▪ Eosinophil
▪ Basophil (See Obj.1.3)
▪ Lymphocyte
▪ Monocyte
▪ Platelet
Basophilic erythroblast
(basophilic normoblast)
Polychromatophilic
erythroblast
(polychromatophilic
normoblast)
Orthochromatophilic
erythroblast
(orthochromic normoblast)
Reticulocyte
(polychromatophilic
erythrocyte)
▪ To use Anderson's Electronic Atlas of Hematology, hit “Click to Start” → “Atlas” → “Blood Cells” →
“Red Blood Cells” → “Normal Maturation Series”
▪ This atlas gives you labeled examples to help you identify each stage of erythropoiesis. Remember that
erythropoiesis is a continuous process. Therefore, a cell may have an appearance that is intermediate between an
earlier and a later stage.
▪ Be able to relate the morphological changes in the cells to changes in organelle content and protein synthesis.
(You should focus on the stages listed in the table above. You do not need to identify every stage of
erythropoiesis shown in this atlas.)
Objective 4: Granulopoiesis: identify the developmental stages of granulocytes. Note the
differences in nuclear and cytoplasmic characteristics, which indicate that a cell has progressed to
the indicated developmental stage.
(See also Table 10.3, pg. 299 and Fig. 10.22, pg. 296)
Promyelocyte
Neutrophilic and
eosinophilic
myelocyte
Neutrophilic and
eosinophilic
metamyelocyte
Neutrophilic and
eosinophilic
band (“stab”)
▪ To use the Electronic Atlas of Hematology, hit “Click to Start” → “Atlas” → “Blood Cells” → “White
Blood Cells” → “Granulocytic Series” →“Normal Maturation”
▪ This atlas contains labeled examples to help you identify each stage. Remember that granulopoiesis is a
continuous process. Therefore, a cell may have an appearance that is intermediate between an earlier stage and a
later stage.
▪ Remember, it is at the myelocyte stage of granulopoiesis that specific granules first appear. At this stage, you
should be able to distinguish neutrophilic myelocytes from eosinophilic myelocytes or basophilic myelocytes.
(You should focus on the stages listed in the table above. You do not need to identify every stage of
granulopoiesis shown in this atlas.)
▪ To use the Electronic Atlas of Hematology, hit “Click to Start” → “Atlas” → “Blood Cells” →
“Megakaryocytic Series” → “Normal Maturation” → “Megakaryocyte”
▪ You only need to examine mature megakaryocytes in this Objective. The large size and unusual shape of the
megakaryocyte nucleus is the end result of nuclear endomitosis. This is a process of chromosome duplication
without nuclear division or cell division. This process can result in a single megakaryocyte nucleus with up to a
64n chromosome number. You can see a diagrammatic representation of a megakaryocyte in Fig. 10.19, pg. 293.
The unusual shape of the megakaryocyte nucleus, when viewed in the two dimensions of a light microscopic
section, may give you the false impression that the megakaryocyte has multiple nuclei. The megakaryocyte
cytoplasm may have fine basophilic granules. The outer edge of the megakaryocyte may be irregular or difficult
to define, due to the peripheral extensions of forming platelets.
Objective 6: Structure of bone marrow
1a. In addition to the elongate “sickled” cells in the image labeled “Sickled Erythrocytes”, what other
morphologic abnormalities do you see among the erythrocytes in this image of peripheral blood?
The most immature stage of erythrocyte development visible in this image is:
A. basophilic erythroblast
B. polychromatophilic erythroblast
C. orthochromatophilic erythroblast
D. reticulocyte
E. erythrocyte
1b. The second image shows a peripheral blood erythrocyte with basophilic stippling.
If this is an abnormal blood smear, list as many abnormalities as you can identify.
3. These images are from a(n):
A. normal blood smear
B. abnormal blood smear
C. normal bone marrow smear
If this is an abnormal blood smear, list as many abnormalities as you can identify.
If this is an abnormal blood smear, list as many abnormalities as you can identify.
If this is an abnormal blood smear, list as many abnormalities as you can identify.
If this is an abnormal blood smear, list as many abnormalities as you can identify.
7. These images are from a section of an acutely inflamed vermiform appendix (appendicitis). What cell type
predominates in this connective tissue? Note the numerous fine, extracellular strands in this tissue. As part of the
inflammatory process, numerous blood cells exit the blood vessels, and the blood coagulation cascade is initiated.
Based upon your understanding of this cascade, of which protein are these fine strands composed?
Self-study Review
2. These images are from a section of chronically inflamed skin (dermatitis). What type of immune cell do you
see? Prominence of which two cytoplasmic organelles is responsible for the cytoplasmic staining of this cell?
6. Compare this image of bone marrow to the images you examined in Objective 6. What differences do you
see? Is this an example of active bone marrow?
Answers to Questions for Blood and Hematopoiesis Laboratory Session
Integrative Questions
2) These images are from an abnormal peripheral blood smear from a case of sickle cell anemia. In addition to
the long, thin, “sickled” erythrocytes scattered in this smear, there are frequent “target” cells (cells in which there
is a focus of staining in the middle of the cell’s area of central pallor). Overall, this smear is characterized by
anisocytosis and poikilocytosis. You should refer to your lecture notes if you are unfamiliar with the terms
“anisocytosis” and “poikilocytosis”.
3) These images are from an abnormal peripheral blood smear from a case of iron deficiency anemia. Image 4
provides you with measurements of the diameters of multiple erythrocytes in this slide. The measurements range
from 5.1µm to 7.1µm, with an average diameter of 6.14µm. Most of these cells are smaller than 7.5µm in
diameter, the average for normal human erythrocytes. You will also notice that, because there is less hemoglobin
within these erythrocytes, the area of central pallor is larger relative to the size of the erythrocyte. Iron deficiency
is characterized by a microcytic hypochromic anemia, as is seen in these images.
4) These images are from an abnormal peripheral blood smear from a patient with chronic myelogenous
(myeloid) leukemia (CML). CML results from a molecular defect in pluripotent hematopoietic stem cells. For
reasons that are not understood, there is a preferential increase in the production of granulocyte precursors. In
time, these precursors can be found in the peripheral blood. Another feature of CML is the appearance of an
unusually large number of basophils. You should be able to find examples of basophils in these images, as well as
clusters of immature granulocytes. You will note that no red blood cell precursors are present in this slide;
therefore, this could not be a normal bone marrow smear.
5) These images are from an abnormal peripheral blood smear taken from an individual with chronic
lymphocytic leukemia (CLL). In CLL, there is increased production of abnormal lymphocytes, which appear in
the peripheral blood. You should be able to identify many examples of lymphocytes in these images. Compare
the relative proportion of lymphocytes in this slide to that seen in the normal peripheral blood smear images you
examined for Objective 1.1 of this Laboratory Session.
6) This is an example of a bone marrow smear. Unlike the abnormal peripheral blood smears which you
examined above, in this view, you can identify erythrocytic precursors as well as granulocytic precursors. Use
Fig. 10.22, pg. 296 in Ross and Pawlina to help you identify the stages visible in this view. Pay particular
attention to how the cells you identify fit into the sequence of erythrocytic and granulocytic maturation.
7) In the 200X magnification images, most of the inflammatory cells present are neutrophils. Neutrophils can be
identified in tissue by their characteristic segmented nuclei. An intense infiltration of neutrophils, as seen here, is
a typical finding in acute inflammation. In areas of such inflammation, the neutrophils may have begun to
degenerate or die, and so may have shrunken, dark nuclei; however, you should still be able to identify
segmentation of these nuclei. Image 6 shows neutrophils enmeshed in strands of fibrin. In Image 5 you can see an
aggregate of fibrin within a blood vessel. To the right of this vessel, and elsewhere in these images, you will see
areas of hemorrhage, indicated by accumulations of erythrocytes outside of the tissue’s vasculature.
1) This image is from a section of ileum, a portion of the small intestine. It includes portions of small lymphatic
vessels, with several lymphocytes in their lumina. Because lymphocytes are so closely arranged in this area, it is
not possible to distinguish plasma cells. Instead, use Self-study Review Question 2 and Objective 2.1 to examine
plasma cells in tissues. Plasma cells have spherical nuclei, which are eccentrically placed. They have a moderate
amount of cytoplasm, which usually stains basophilic, due to the presence of rough endoplasmic reticulum. In the
cytoplasm adjacent to the nucleus of many plasma cells you will find a pale or unstained area, which represents
the Golgi apparatus. Lymphocytes have nuclei similar in appearance to those of plasma cells. However,
lymphocytes have cytoplasm which is so sparse that it may not be visible in tissue section.
2) This image is from an area in which plasma cells have accumulated around a small blood vessel in the dermis
of the skin (dense irregular connective tissue). These plasma cells have characteristic round nuclei, some with
“clock face” clumping of heterochromatin. The nuclei are eccentrically placed. Plasma cells have moderate
amounts of basophilic cytoplasm. This cytoplasmic basophilia is due to ribosomes on the high concentration of
rough endoplasmic reticulum. Many of these cells have a prominent Golgi apparatus, evident as an area of pale
staining or unstained cytoplasm next to the nucleus.
3) Keep in mind the decision flow chart in the Introduction to this Laboratory Session as you examine this image.
First, cells in the erythropoiesis series will have agranular cytoplasm. The nuclei are always round, but will
become smaller and darker as the cell progresses in maturation. The nuclei will usually, but not always, be
centrally placed in the cell until they are ready to be extruded. In the orthochromatophilic erythroblast
(normoblast) stage, the nucleus is small and very condensed. There are four examples of cells in the
erythropoiesis series in this image. The cytoplasm of basophilic erythroblasts is intensely basophilic. The upper
left cell with the round nucleus fits the description of a basophilic erythroblast. The slightly smaller cell near the
top center of this image also has basophilic cytoplasm. However, the smaller size of the cell and its nucleus, as
well as the faintly "checkerboard" pattern of its chromatin, is consistent with a polychromatophilic erythroblast.
In the later stages of erythropoiesis, as the cell gains hemoglobin, the cytoplasm becomes pink/gray, and finally
becomes the same color as that of the mature erythrocyte cytoplasm.
4) When identifying any of the developing blood cells, keep in mind the decision flow chart given in the
Introduction to this Laboratory Session. Check for the presence of cytoplasmic granules. These are present in cells
of the granulocytic series. Next, examine the nucleus of the cell. The nucleus of the cell on the far left is flattened
on one side, and is eccentrically placed in the cell. These characteristics, and the appearance of the chromatin,
indicate that this is a myelocyte. On the far right, there are three cells of the granulocytic series, all of which have
indented nuclei. Two of these are examples of metamyelocytes. The third is in transition from metamyelocyte to
band cell (also called stab cell) stage. The nuclear characteristics of the cell of the granulocytic series in the center
of this view are consistent with those of a band cell. In stages in which specific granules are present, you can use
the type of granule seen to determine which type of granulocyte (neutrophil, eosinophil, basophil) you are
examining. None of the cells in this view have granules consistent with those seen in either eosinophils or
basophils. The cells of the granulocytic series in this view are all in the neutrophilic line.
5) An eosinophilic myelocyte should have eosinophilic granules, and a nucleus which is flattened on one side.
The nucleated cell to the right of center in this image fits that description.
6) Notice the large number of adipocytes, with intervening hematopoietic cells. Compare the number of
adipocytes in this marrow to the number of adipocytes found in the marrow you examined for Objective 6? The
marrow in Objective 6 is composed almost entirely of hematopoietic elements. It is active bone marrow. In
inactive marrow, as seen in the image for this question, there will be much higher relative numbers of adipocytes
when compared to active marrow. The marrow shown in the image for this question is an example of inactive
marrow.