مهههههههههههههم عن الدم

Value of CBC
 Screening test for diagnosis of many diseases.
 Indicator of body’s ability to fight disease.
 Monitor the effects of drugs and radiation therapy.
 Follow up the patient’s progress in certain diseases (e.g. anaemia & infection …etc)
Blood Leucocytes:
 Total & Differential Count
 Absolute & Relative Count
 Normal Leucocytic count.
Children ,Adult
 Corrected Leucocytic count .

Total & Differential Count
Total Leucocytic count .
Factors affecting ( physio. & patholo.) .
Normal values ( Adult & Pediatrics) .
Differential Leucocytic count .
Manual Vs Automated .count .
Factors affecting Diff. count .
Spreading .
Storage .
Absolute & Relative count .
Abs. count = TLC X Relative count .

Corrected Leucocytic Count
Example :
Total Nucleated Cells (TNC) = 30,000 / cmm
Normoblasts = 150/ 100 WBC
No of cell counted =250 N0 of WBCs = 100
TNC = 30,000 Correcter WB Cs : ?
So Corrected WBCs = 30,000 X 100/ 250 = 12,000
Corrected WBCs =
TNC X 100 /100+Normoblast per/ 100 WBC

Normal Mature Leukocytes
Cellular Differentiation Balance
Cell size (variable)
Cytoplasm :
Color
Granules : granules number
Size Color & Location

Nucleus :
N/C ratio
Nuclear shape (Round, oval ,segmented .etc…)
Location to the cell wall
Nuclear condensation

Nucleolei :
Size Shape Numbers
Perinucleolar condensation

Myelocytic Maturation Series:
Myeloblast
Promyelocyte
Myelocyte
Metamyelocyte
Band Neutrophil
Segmented Neutrophil

**Hematopoiesis: Blood Cell Formation

كل العداوة قد ترجى مودتها إلا عدواة من عاداك عن حسد

Differential WBCs :
• Usually performed by visual examination of stained blood films which are prepared on slides by the spread or wedge technique
Normal differential WBCs :
• Neutrophils : 40-70 % (2000 - 7000/cmm)
• Lymphocytes: 20-40 % (1000 - 3000/cmm)
• Monocytes : 2-10% ( 200 - 1000/cmm)
• Eosinophils : 1-6 % (20-500/cmm)
• Basophils : 0 -1 % ( 20 - 100 /cmm)

Neutrophils )

• Size of the cell: 14 - 20 mm
• Shape of the cell: oval or round
• Colour of cytoplasm: pink
• Granularity: a few azurophilic and neutrophilic, different in number granulation
• Nucleus' shape: obulated (normally less than 5 lobes
• Type of chromatin: condensed
• Nuclear/cytoplasmic ratio: low or very low
• Nucleoli: not visible
• Occurrence:
blood: 40 - 75 %
marrow: 5 - 20 % * Magnification: x 1000

Eosinophils : )

• Size of the cell: 15 - 25 mm
• Shape of the cell: oval or round
• Colour of cytoplasm: pale, covered by granules
• Granularity: abundant eosinophilic (orange-red)
• Nucleus' shape: lobulated, semicircular
• Type of chromatin: condensed
• Nuclear/cytoplasmic ratio: low or very low
• Nucleoli: not visible
• Occurrence:
blood: 2 - 4 %
marrow: < 2 %

BASOPHILS  )
• Size of the cell: 12 - 18 mm
• Shape of the cell: round or oval
• Colour of cytoplasm: light-pink, mostly covered by granules and nucleus
• Granularity: very dark, basophilic, granules of various size. The amount varies
• Nucleus' shape: oval shaped in not mature forms; lobular shaped in mature forms
• Type of chromatin: condensed, pale
• Nuclear/cytoplasmic ratio: low or very low
• Nucleoli: not visible

MONOCYTES ()
• Size of the cell: 15 - 25 mm
• Shape of the cell: round, oval or irregular
• Colour of cytoplasm: grey-blue
• Granularity: absent or a few, azurophilic, very fine granules
• Nucleus' shape: usually irregular
• Type of chromatin: coarse chromatin, clumped
• Nuclear/cytoplasmic ratio: moderate or low
• Nucleoli: not visible
• Occurrence:
blood: 4 - 8 %
marrow: < 2 %

Lymphocyte ()
Provide a specific immune response to
infectious diseases.
There are 2 types: -
• Tcell
• Bcell *They produce antibodies
LARGE GRANULAR LYMPHOCYTES )
• Size of the cell: 15 - 25 mm
• Shape of the cell: irregular
• Colour of cytoplasm: blue
• Granularity: a few, thick azurophilic granules
• Nucleus' shape: oval, irregular
• Type of chromatin: fine, homogenous
• Nuclear/cytoplasmic ratio: moderate or low
• Nucleoli: not visible *Occurrence blood: < 10 %

Reactive Lymphocyte: ()

Differential WBCs

• Usually performed by visual examination of stained blood films which are prepared on slides by the spread or wedge technique

Normal differential WBCs :
Neutrophils : 40-70 % (2000 - 7000/cmm)
Lymphocytes: 20-40 % (1000 - 3000/cmm)
Monocytes : 2-10% ( 200 - 1000/cmm)
Eosinophils : 1-6 % (20-500/cmm)
Basophils : 0 -1 % ( 20 - 100 /cmm)

Neutrophilia ()

A. Physiological
• At birth
• Physical exercise.
• Emotion
• Pregnancy.
• Following partum

B. Pathological
1. Infective.
• Pyrogenic: staphylococci, streptococci, pneumococci, and gonococci.
• Non pyrogenic: rheumatic fever, scarlet fever, diphtheria and poliomyelitis.
• Septicemia.

2.Haemorrhage.
intraserous, trauma: surgical, fracture, crush and burns
3.Malignant disease.
carcinoma and sarcoma
4.Cardiac disorders.
infarction
5. Drugs and chemical poisoning.
phenacetin and adrenaline
6. Metabolic disturbances.
renal failure, diabetic coma , gout , eclampsia.
7. Myeloid leukemia.
CML and PRV
8. Collagen disease.
PAN, rheumatoidarthritis, acute exacerbation of SLE
9. Miscellaneous
Serum sickness accompanying intravascular haemolysis.

Neutropenia 
1. Infection.
Bacterial: typhoid and paratyphoid.
Viral: influenza, rubella measles and herpes.
Protozoal: malaria and kala azar
2. Acute leukemia
3. Drug induced neutropenia
4. Aplastic anemia
5. Hypersplenism
6. Idiopathic neutropenia

7. Bone marrow infiltration
• Secondary carcinoma.
• Malignant lymphoma.
• Myelosclerosis.
• Multiple myeloma.
8. Megaloblastic anemia
9. DLE
10. Iron deficiency anemia
11. Malignant disease
12. Post irradiation.

Lymphocytosis ()

1. Infection:
• Influenza.
• Brucellosis.
• Secondary syphilis.

• Typhoid.
• TB.
2. Exanthema: initial stage of the following
• Rubella
• Chiken pox.
• Mumps.
3. Lymphocytic leukemia.
4. NHL.

5. Infectious mononucleosis.
6. Toxoplasmosis.
7. Infective hepatitis.
8. Miscellaneous:
• Myasthenia gravis.
• Hypothyroidism
• Thyrotoxicosis.
• Multiple myelomatosis

Monocytosis  ()
1.Bacterial infection:
• Tuberculosis
• Brucellosis
• Subacute bacterial
• Endocarditic
2.Protozoal and ricketsial diseases:

• Malaria.
• Typhus.
• Kala azar
• Trypanosoma
3.Infectious mononucleosis:
4.HD.
5. NHL.
6. Monocytic lekemia.
7. Chronic idiopathic neutropenia.
8. Rheumatic arthritis, collagenic disease.
9. Chronic ulcerative colitis.
10. Carcinoma.

Basophilia  ()

1- Myeloproliferative disorders, particularly CML.
2- PRV.
3- Iron deficiency anemia.
4. Reactive immunologic conditions (e.g. IgE-mediatea hypersensitivity).
5. Chronic inflammatory disorders (e.g. rheumatoid arthritis, ulcerative colitis).
6. Viral infections.
7.Following radiation

Qualitative WBCs Disorders 

Neutrophilia – shift to right(
Hypersegmented Neutrophils -98% à very specific to megaloplastic anemia

إعـــــــلان

مهههههههههههههم عن الدم

اترك تعليق:

اترك تعليق:

اترك تعليق:

اترك تعليق:

اترك تعليق:

اترك تعليق:

اترك تعليق:

اترك تعليق:

اترك تعليق:

اترك تعليق:

اترك تعليق:

اترك تعليق:

اترك تعليق:

اترك تعليق:

اترك تعليق: