Bone Marrow PK

8/12/2019 Bone Marrow PK

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Peripheral Blood

The formed elements of peripheral blood include red

blood cells (RBCs), white blood cells (WBCs) and

platelets.

Except for a small percentage of slightly immatureRBCs, i.e., reticulocytes, the RBCs are

homogeneous.

WBCs include a) nongranular leukocytes, i.e.,lymphocytes and monocytes, and b) granular

leukocytes, i.e., neutrophils, eosinophils and

basophils.

Platelets are small, non-nucleated cell fragments.


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Slide 83

Image 1

The most numerous cell is the RBC. Its biconcave shape renders its center thinner (in thin smears)

than the edges so the hemoglobin filling the cell stains more deeply at the perimeter.

The small lymphocyteis a small, round, blue-staining cell. Its heterochromatic nucleus is round,

dark staining, and nearly fills the cell, leaving only a thin rim of light blue cytoplasm in which an

occasional small blue lysosome may be noted. Small lymphocytes are about 6 - 9 microns in

diameter or about the same size as RBCs. Medium lymphocytes can be 2X as large with more

cytoplasm and a less dense nucleus.

The neutrophilic granulocyte is the largest cell in the field - twice the size of RBCs. Its nucleus is

lobated and dark staining. Its cytoplasm is filled with small salmon-colored inconspicuousgranules, which are frequently hard to recognize in the pink cytoplasm.

RBCs , 7-8

Sm. Lymphocyte, 6-9

Neutrophil, 15 Lymphocyte

RBC

Neutrophil


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Slide 83 Image 2

The basophils lobated nucleus is often hidden by the coarse blue-purple

granules of its cytoplasm. Neutrophilic granules are poor-staining and often

hard to distinguish in neutrophils. The nucleus of the neutrophil may have 3

- 5 lobes. The eosinophil has coarse red granules; its nucleus often has 2 or

3 lobes.

Basophil, 15(with neutrophil)

Neutrophil, 15Eosinophil, 15


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Slide83Image 3

Monocytes are about twice the size of the small lymphocyte or

RBC. Its nucleus is not very heterochromatic, but is often

indented or folded. Its abundant cytoplasm stains gray-blue

and may contain occasional lysosomes. Lymphocytes have a

more heterochromatic nucleus and a sky-blue cytoplasm.

Monocyte, 15Lymphocytes

Small

Medium


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Monocyte

Slide 83 Image 4

Summary slide.

Granular leukocytes: neutrophil, eosinophil, basophil.

Non-granular leukocytes: lymphocytes, monocyte.

Eosinophil

Lymphocytes

NeutrophilNeutrophil

Basophil


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Demo Slide

Image 5

Bone marrow , r ib, paraf f in sect ion -low mags.Actively hemopoietic (red) marrow is filled with developing RBCs, WBCs,platelets, and lymphocytes. Reticular ct supports the developing cells.Large, light staining fat cells vary in number. Colonies of dark staining cellsare developing RBCs, usually situated at the edge of blood-filled sinuses.Megakaryocytes are large pink cells also obvious near the sinuses. The

remaining cells are mostly developing granulocytes.

Fat cell

Sinus

RBCs

Granulocytes

Megakaryo.

Periosteum

Outer cortical bone

Marrow cavity


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The study of bone marrow from smears

Bone marrow is usually removed by suction from the

iliac crest. A small fragment of the semi-solid marrow

is placed between two glass coverslips, which gently

compresses it. Coverslips are then pulled across eachother spreading the cells of the marrow into a thin

film. The marrow smear is then stained with a blood

stain such as Wrights or Giemsa. These stains are

good for distinguishing the subtleties of thedeveloping granules, cytoplasm and nuclei. Unlike the

usual histologic stains, which cause nucleoli to appear

dark, blood stains leave nucleoli pale.

B M S


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Bone Marrow Smear

Bone Marrow smear at low mag. Whole cells are spread thinly to revealcellular details for further identification under oil immersion magnification.


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CFU-GM

Promyelocyte

Myeloblast

CFU-GCFU-M

Myelocytes

CFU-E

Proerythroblast

Monocyte

Monoblast

Megakaryoblast

Megakaryocyte

Platelets

Lymphoblasts

(T & B)

CFU-L

Pluripotential Stem Cell

Lymphocyte

& Plasma cell

Polychrome

Basophilic

Erythroblast

Metamyelocytes

CFU-Meg

Orthochrome

Mature granulocytesRBC

CFU-GEMM

CFU-Eo CFU-Bas


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RBC & Granulocyte DevelopmentMyeloblast Promyelocyte Myelocyte Metamyelocyte Juvenile Mature

Proerythroblast Baso-erythroblast Polychrome- Orthochrome RBC

Pluripotential

Stem Cell

rare


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Bone marrow , paraf f in sect ion -low mag.Megakaryocytes are large pink cells also obvious near the

sinuses. The remaining cells are mostly developinggranulocytes.

Megakaryocyte

Megakayocytes


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Megakayocyte

Mature

The megakaryocytebegins its development from a megakaryoblast which

closely resembles all other blast cells. Early in development it undergoes

mitotic divisions to increase its numbers but finally it undergoes only

endomitotic divisions. This results in no additional cells but the cell increases

dramatically in size and nuclear complexity. The cytoplasm is abundant and

finley granular; the nucleus remains single but it is highly lobulated.

Megakayocyte, ~ 200


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Slide 83 Image 5/5

Platelet

Platelet

Platelets are cell fragments whose size varies between 2 - 4microns (compare to RBC, 7 , neutrophil 15 ) . They have no

nuclei, their cytoplasm stains light blue and is slightly granular.

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