NORMAL BLOOD VALUES. SHEIKHA NORMAL HEMATOLOGICAL VALUES.

NORMALBLOOD VALUES

SHEIKHA

NORMAL

HEMATOLOGICAL

VALUES

10 trillion “1013” new blood cells must be replaced Each day to maintain steady state blood counts!

This is equivalent to an annual number of cells approximating the total body weight, but the totalbone marrow of an adult human contains around1012 cells, 10 fold less than the daily need!

Marrow contains 1 stem cell per 20 million nucleated cells

Normal Normal

ValuesValues

MEN WOMENCORD

CHILD 3 m

RCC+/- 0.5X1012/L

5.0 4.3 5.0 4.0

HbHbgm/dLgm/dL

13.0 13.0 toto

17.017.0

12.0 12.0

toto

15.015.0

13.5 13.5 toto

19.519.5

9.59.5

toto

13.513.5

Hct.Hct.

(PCV)(PCV)

40%40%

toto

54%54%

36%36%

toto

46%46%

44%44%

toto

64%64%

32%32%

toto

44%44%

MCV (fL)MCV (fL) 76-76-9696

76-9676-96 106106 9696

The Sheikhas

1818 cubic meters

1800 kilos

Normal ValuesNormal Values

= ------------ = ------------ == ------------ = ------------ =

= ------------ = -------- = 90 fL= ------------ = -------- = 90 fL

Mean Cell VolumeMean Cell Volume

MCV

PCV

RCC

0.45 L

5.0 x 1012

0.45 x 1015 fL

5.0 x 1012

450

5.0

NORMAL MCV = 76 – 96 fL

SHEIKHA

0.45L

5X

1012

1 L

Normal Normal ValuesValues

= ------------ = ------------ == ------------ = ------------ =

= ----------- = ------------ = 30 pg = ----------- = ------------ = 30 pg

Mean Cell Mean Cell HemoglobinHemoglobin

MCH

Hb

RCC

15 gm/dL

5.0 x 1012/L

5.0 x 1012/L

150 gm/L 150 x 1012 pg

5.0 x 1012/L

NORMAL MCH = 27 – 32 pg

SHEIKHA

15gm/dL

5 trillion

1 Liter

Normal ValuesNormal Values

= ------------ = ------------ == ------------ = ------------ =

= 333 g/L = 33 g/dL= 333 g/L = 33 g/dL

Mean Cell VolumeMean Cell Volume

MCHC

Hb

PCV

150 g/L

0.45 L/L

NORMAL MCHC IN ADULTS & CHILDREN = 32 – 36 g/dL

SHEIKHA

0.45150gm

RETICULOCYTE COUNTRETICULOCYTE COUNT

0.2 to 2.0%

=10,000 to 100,000/uL (Adults & Children)

2.0 to 6.0%Mean = 150,000

(Infants/ Cord Blood)

BLOOD VOLUMEBLOOD VOLUME

60 to 80 ml/Kg60 to 80 ml/Kg

PLASMA

PCV

55%

45%

40 to 50 ml/Kg

Men: 25 to 35 ml/KgWomen: 20 to 30 ml/Kg

SHEIKHA

Differential White Cell CountsDifferential White Cell Counts

Total WBC: Total WBC: 4.0 to 11.0 X 104.0 to 11.0 X 109 9 / L/ L

4,000 to 11,000 / uL4,000 to 11,000 / uL

<100

Neutrophils

Lymphocytes

Monocytes

Eosinophils

Basophils

2,000to

7,500/uL1,500

to4,000/uL

200to

800

40to

440

SHEIKHA

BLOOD CELLS LIFE SPANBLOOD CELLS LIFE SPAN

10 days

120days T1/2

7 hours

RBCWBC

Platelet

SHEIKHA

Iron statusIron status

Serum Iron UIBC

TIBC

13 – 32 umol /L

100 ug /L

45 – 70 umol /L

300 ug /L

Male: 30-300 ug/L Female: 15-200

FERRITIN

SHEIKHA

CBCCBC

NormalNormal

M: 13-17 M: 13-17 F: 12-15F: 12-15

M: M: 40-54%40-54% F: F: 36-46%36-46%

+/- 0.5+/- 0.5 M: M: 5X105X101212/L/L F: F: 4.3X104.3X101212//LL

76-9676-96

27-3227-32

32-3632-36

0.2-2.00.2-2.0

11.5-14.511.5-14.5

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

NormalNormal

4,000 – 11,000/uL4,000 – 11,000/uL2,000 – 7,500/ uL2,000 – 7,500/ uL

1,500 – 4,000/1,500 – 4,000/ uL uL200 – 800/ uL200 – 800/ uL

40 – 440/ uL40 – 440/ uL

<100/ uL<100/ uL

WBCWBCNeutrophilsNeutrophils

LymphocyteLymphocytess

MonocytesMonocytes

EosinophilsEosinophils

BasophilsBasophils

Blasts:Blasts:

PromyelocytePromyelocytes:s:

Myelocytes:Myelocytes:

MetamyelocyteMetamyelocytes:s:

Band or Band or Stab:Stab:

NormalNormal

150,000 – 150,000 – 400,000/uL400,000/uL

5.0 - 8.0 fL5.0 - 8.0 fL

0.1 - 0.4 %0.1 - 0.4 %

PlateletsPlatelets

MPVMPVPlateletcriPlateletcritt

PDWPDW

Platelet in Platelet in smearsmear

200 X 109/L X 5 fL= 1000 X 109 fL of platelets/L of blood =1.0 X 1012 fL/L = 1 ml of platelets/L of blood =

0.1%

400 X 109/L X 8 fL= 3200 X 109 fL of platelets/L of blood = 3.2 X 1012 fL/L = 3.2 ml of platelets/L of blood =

0.3%

Total Platelet Mass in an adult ~ 5 to 20 mls

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





Platelets

MPVPlateletcrit

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





Platelets

MPVPlateletcrit

CASES

CLINICAL AND LAB.DATA

Case 1HAYASA50 years

Patient: Back Pain Smear: Rouleaux Marrow: 80% PCs ESR: 110 mm/hr

?Dx:

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic.

RDWRDW

12.012.0

0.350.35

4.04.0

8888

3030

3434

22%%

1515%%



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





4.44.4

60%60%

30%30%

8%8%

2%2%

Platelets

MPVPlateletcrit

200,000

66



?Dx:

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

12.012.0

0.350.35

4.04.0

8888

3030

3434

22

1515



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





4.44.4

60%60%

30%30%

8%8%

2%2%

Platelets

MPVPlateletcrit

200,000

66



?Dx:

MULTIPLE MYELOMA

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.280.28

4.04.0

7070

2020

2828

1111

1717



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





11.011.0

55%55%

35%35%

5%5%

3%3%

2%2%

Platelets

MPVPlateletcrit

8,008,0000

10100.0080.008

%%

CASE 2

ALI HADI3 years

BruisesEpistaxisHematuria

Mild splenomegaly

Marrow full of Megakaryocytes

Smear: Few Giant platelets

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.0

0.280.28

4.04.0

7070

2020

2828

1111

1717



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





11.011.0

55%55%

35%35%

5%5%

3%3%

2%2%

Platelets

MPVPlateletcrit

8,008,0000

10100.0080.008

%%

CASE 2

ALI HADI3 years

BruisesEpistaxisHematuria

Mild splenomegaly

Marrow full of Megakaryocytes

Smear: Few Giant platelets

I T P

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

4.04.00.120.12

1.251.25

9696

3232

3333

0%0%

1414



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





8.08.0

60%60%

30%30%

08%08%

02%02%

Platelets

MPVPlateletcrit

200,00200,0000

770.14%0.14%

Case 3

Abu Bakr30 years

IndianSevere pallorGiven 3 units of RBC

Marrow devoid of RBC precursors

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

4.04.00.120.12

1.251.25

9696

3232

3333

0%0%

1414



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





8.08.0

60%60%

30%30%

08%08%

02%02%

Platelets

MPVPlateletcrit

200,00200,0000

770.14%0.14%

Case 3

Abu Bakr30 years

IndianSevere pallorGiven 3 units of RBC

Marrow devoid of RBC precursors PRCA

Pure Red Cell Aplasia

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.0

0.350.35

4.34.3

8080

2525

3131

2%2%

1313



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





166166

40%40%

6%6%

1%1%

5%5%

3%3%

2%2%

3%3%

25%25%

5%5%

10%10%Platelets

MPVPlateletcrit

400,00400,0000

770.28%0.28%

Case 4

Sultan48 years

Loss of weightModerate splenomegalyMild hepatomegaly

Positive Philadelphia chromosome

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.0

0.350.35

4.34.3

8080

2525

3131

2%2%

1313



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





166166

40%40%

6%6%

1%1%

5%5%

3%3%

2%2%

3%3%

25%25%

5%5%

10%10%Platelets

MPVPlateletcrit

400,00400,0000

770.28%0.28%

Case 4

Sultan48 years

Loss of weightModerate splenomegalyMild hepatomegaly

Positive Philadelphia chromosome CML

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

15.015.0

0.450.45

5.05.0

9090

3030

3333

1.5%1.5%

1212



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





4646

50%50%

10%10%

4%4%

4%4%

2%2%

2%2%

4%4%

8%8%

16%16%Platelets

MPVPlateletcrit

200200

12120.12%0.12%

Case 5Yahia

20 years

Hyperpyrexia

Streptococcal tonsillitis

High NAP score

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

15.015.0

0.450.45

5.05.0

9090

3030

3333

1.5%1.5%

1212



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





4646

50%50%

10%10%

4%4%

4%4%

2%2%

2%2%

4%4%

8%8%

16%16%Platelets

MPVPlateletcrit

200200

12120.12%0.12%

Case 5Yahia

20 years

Hyperpyrexia

Streptococcal tonsillitis

High NAP score

LEUKEMOID REACTION

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.0

0.220.22

2.82.8

7878

2828

3535

22

12.012.0



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





2828

5%5%

15%15%

80%80%

Platelets

MPVPlateletcrit

20,0020,0000

550.01%0.01%

Case 6FAHAD

8 YEARS

FeverChest InfectionGum BleedingPallor

Blood smear & marrow are full of PAS +ve blasts

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.0

0.220.22

2.82.8

7878

2828

3535

22

12.012.0



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





2828

5%5%

15%15%

80%80%

Platelets

MPVPlateletcrit

20,0020,0000

550.01%0.01%

Case 6FAHAD

8 YEARS

FeverChest InfectionGum BleedingPallor

Blood smear & marrow are full of PAS +ve blasts ALL

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.280.28

2.92.9

9797

2727

2929

22



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





2.02.0

40%40%

20%20%

4%4%

5%5%

1%1%

5%5%

5%5%

5%5%

5%5%

10%10%Platelets

MPVPlateletcrit

100,00100,0000

66

0.060.06

Case 7Abdul Rahman

16 Years

Anemia not responding to RHypogranular neutrophilsHypercellular marrow12% Marrow Blasts

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.280.28

2.92.9

9797

2727

2929

22



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





2.02.0

40%40%

20%20%

4%4%

5%5%

1%1%

5%5%

5%5%

5%5%

5%5%

10%10%Platelets

MPVPlateletcrit

100,00100,0000

66

0.060.06

Case 7Abdul Rahman

16 Years

Anemia not responding to RHypogranular neutrophilsHypercellular marrow12% Marrow Blasts

RAEB

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

6.06.00.360.36

6.06.0

6060

1010

1717

66

1818



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





nRBCnRBC

6060

30%30%

20%20%

5%5%

5%5%

40%40%

Platelets

MPVPlateletcrit

300,00300,0000

880.24%0.24%

Case 8SHADI8 Years

Hypochromic microcytic red cellsTarget cellsMarked increase of nRBCHbF= 100%Splenectomized

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

6.06.00.360.36

6.06.0

6060

1010

1717

66

1818



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





nRBCnRBC

6060

30%30%

20%20%

5%5%

5%5%

40%40%

Platelets

MPVPlateletcrit

300,00300,0000

880.24%0.24%

Case 8SHADI8 Years

Hypochromic microcytic red cellsTarget cellsMarked increase of nRBCHbF= 100%Splenectomized

β- THALASSEMIA MAJOR

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

6.06.00.220.22

2.02.0

110110

3030

2727

4%4%

1717



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





2828

8%8%

10%10%

2%2%

2%2%

2%2%

60%60%

4%4%

4%4%

4%4%

4%4%Platelets

MPVPlateletcrit

3030

11110.030.03

Case 9SAUD NAIF60 Years

Perianal abscess

Marrow: Hypercellular; Abnormal pronormoblasts & myeloblasts forming majority of the cells

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

6.06.00.220.22

2.02.0

110110

3030

2727

4%4%

1717



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





2828

8%8%

10%10%

2%2%

2%2%

2%2%

60%60%

4%4%

4%4%

4%4%

4%4%Platelets

MPVPlateletcrit

3030

11110.030.03

Case 9SAUD NAIF60 Years

Perianal abscess

Marrow: Hypercellular; Abnormal pronormoblasts & myeloblasts forming majority of the cells

Erythroleukemia

(AML M6)

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

10.010.00.260.26

5.25.2

5050

1919

3838

1212

1414



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





1010

70%70%

25%25%

5%5%

Platelets

MPVPlateletcrit

280,00280,0000

66

0.170.17

Case 10MAHA RUSHDI

17 Years

Mild Pallor & Jaundice

Positive Family history

Smear: Small & hyper- chromic red cells

High MCHC

+ Osmotic Fragility Test

Moderate splenomegaly

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

10.010.00.260.26

5.25.2

5050

1919

3838

1212

1414



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





1010

70%70%

25%25%

5%5%

Platelets

MPVPlateletcrit

280,00280,0000

66

0.170.17

Case 10MAHA RUSHDI

17 Years

Mild Pallor & Jaundice

Positive Family history

Smear: Small & hyper- chromic red cells

High MCHC

+ Osmotic Fragility Test

Moderate splenomegaly

HEREDITARY

SPHEROCYTOSIS

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

9.09.00.300.30

3.23.2

9595

2828

3030

1010

1616



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





3737

46%46%

6%6%

20%20%

4%4%

4%4%

4%4%

4%4%

4%4%

4%4%

4%4%Platelets

MPVPlateletcrit

400,00400,0000

88

0.320.32

Case 11SAED AL-NAMI

70 Years

Massive splenomegalyNegative Ph’ ChromosomeMarrow: Hypercellular with agranular & hypogranular neutrophils

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

9.09.00.300.30

3.23.2

9595

2828

3030

1010

1616



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





3737

46%46%

6%6%

20%20%

4%4%

4%4%

4%4%

4%4%

4%4%

4%4%

4%4%Platelets

MPVPlateletcrit

400,00400,0000

88

0.320.32

Case 11SAED AL-NAMI

70 Years

Massive splenomegalyNegative Ph’ ChromosomeMarrow: Hypercellular with agranular & hypogranular neutrophils

CMML

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.300.30

4.34.3

7070

1919

2727

55

1616



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





1111

7070

2525

44

11

Platelets

MPVPlateletcrit

280,00280,0000

66

0.170.17

Case 12HUDA RDENY

20 Years

Severe back painSplenic atrophyHb-electrophoresis is pendingTargets & sickle cells

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.300.30

4.34.3

7070

1919

2727

55

1616



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





1111

7070

2525

44

11

Platelets

MPVPlateletcrit

280,00280,0000

66

0.170.17

Case 12HUDA RDENY

20 Years

Severe back painSplenic atrophyHb-electrophoresis is pendingTargets & sickle cells

Hb SS

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

12.012.0

0.350.35

4.14.1

8585

2929

3434

44

1414



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





7676

30%30%

4%4%

2%2%

2%2%

2%2%

18%18%

4%4%

28%28%

5%5%

5%5%Platelets

MPVPlateletcrit

380,00380,0000

88

0.3%0.3%

Case 13ABDU ABDU

24 Years

Massive splenomegaly+ Ph’ ChromosomeStarted on Hydrea

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

12.012.0

0.350.35

4.14.1

8585

2929

3434

44

1414



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





7676

30%30%

4%4%

2%2%

2%2%

2%2%

18%18%

4%4%

28%28%

5%5%

5%5%Platelets

MPVPlateletcrit

380,00380,0000

88

0.3%0.3%

Case 13ABDU ABDU

24 Years

Massive splenomegaly+ Ph’ ChromosomeStarted on Hydrea

CML

“Accelerated Phase”

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

12.012.00.350.35

4.14.1

8585

2929

3434

22

1313



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





1212

82%82%

8%8%

6%6%

4%4%

2%2%

Platelets

MPVPlateletcrit

300,00300,0000

77

0.210.21

Case 14Al-Hifzi

18 Years

HemarthrosisNormal P.T.Prolonged APTTNormal Bleeding TimeHIV Positive

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

12.012.0

0.350.35

4.14.1

8585

2929

3434

22



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





1212

82%82%

8%8%

6%6%

4%4%

2%2%

Platelets

MPVPlateletcrit

300,00300,0000

77

0.210.21

Case 14Al-Hifzi

18 Years

HemarthrosisNormal P.T.Prolonged APTTNormal Bleeding TimeHIV Positive

HEMOPHILIA A

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

6.06.00.180.18

2.22.2

8282

2727

3333

1818

1414



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





2.22.2

40%40%

50%50%

8%8%

2%2%

Platelets

MPVPlateletcrit

40,0040,0000

990.04%0.04%

Case 15AISHA

17 Years

Huge SpleenFever

Marrow was requested to exclude an intracellular parasitic disease

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

6.06.00.180.18

2.22.2

8282

2727

3333

1818

1414



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





2.22.2

40%40%

50%50%

8%8%

2%2%

Platelets

MPVPlateletcrit

40,0040,0000

990.04%0.04%

Case 15AISHA

17 Years

Huge SpleenFever

Marrow was requested to exclude an intracellular parasitic disease Kala Azar

“Visceral Leishmaniasis”

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.00.350.35

4.34.3

8181

2626

3131

22

1313



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





1010

50%50%

40%40%

8%8%

2%2%

Platelets

MPVPlateletcrit

140,00140,0000

880.11%0.11%

Case 16FATMA

48 Years

Six months history ofcervical lymphadenopathy (biopsy pending)ESR 80 mm/hrHepatosplenomegalyMarrow: normal

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.00.350.35

4.34.3

8181

2626

3131

22

1313



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





1010

50%50%

40%40%

8%8%

2%2%

Platelets

MPVPlateletcrit

140,00140,0000

880.11%0.11%

Case 16FATMA

48 Years

Six months history ofcervical lymphadenopathy (biopsy pending)ESR 80 mm/hrHepatosplenomegalyMarrow: normal

? Lymphoma

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.00.350.35

4.34.3

8181

2626

3131

22

1313



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





160160

3%3%

95%95%

1%1%

1%1%

Platelets

MPVPlateletcrit

140.00140.0000

cervical lymphadenopathyESR 80 mm/hrHepatosplenomegalyMarrow: 80% mature lymphocytes

Case 17ABDULLAH68 Years

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.00.350.35

4.34.3

8181

2626

3131

22

1313



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





160160

3%3%

95%95%

1%1%

1%1%

Platelets

MPVPlateletcrit

140.00140.0000

cervical lymphadenopathyESR 80 mm/hrHepatosplenomegalyMarrow: 80% mature lymphocytes

CLL

Case 17ABDULLA

H68 Years

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

21.021.0

0.640.64

7.27.2

8888

2929

3333

44



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





2121

50%50%

20%20%

5%5%

5%5%

2%2%

1%1%

1%1%

2%2%

6%6%

8%8%Platelets

MPVPlateletcrit

800,00800,0000

1010

0.8%0.8%

Case 18ZHARA

60 Years

PlethoricHeadacheRetinal vein thrombosisHot bath induced pruritisProlonged Bleeding Time

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

21.021.0

0.640.64

7.27.2

8888

2929

3333

44



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





2121

50%50%

20%20%

5%5%

5%5%

2%2%

1%1%

1%1%

2%2%

6%6%

8%8%Platelets

MPVPlateletcrit

800,00800,0000

1010

0.8%0.8%

Case 18ZHARA

60 Years

PlethoricHeadacheRetinal vein thrombosisHot bath induced pruritisProlonged Bleeding Time

PRV

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.260.26

3.23.2

8181

2525

3131

1414

1616



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





1111

60%60%

35%35%

4%4%

1%1%

Platelets

MPVPlateletcrit

350,00350,0000

880.28%0.28%

Case 19Bel Gasim

6 Years

Mild JaundiceDark Urine

Rapid drop of HbMarked polychromasiaNegative Coomb’sReceived malaria prophylaxis before a family trip to red sea

Heinz Bodies

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.260.26

3.23.2

8181

2525

3131

1414

1616



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





1111

60%60%

35%35%

4%4%

1%1%

Platelets

MPVPlateletcrit

350,00350,0000

880.28%0.28%

Case 19Bel Gasim

6 Years

Mild JaundiceDark Urine

Rapid drop of HbMarked polychromasiaNegative Coomb’sReceived malaria prophylaxis before a family trip to red sea

G6PDH Deficiency

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

4.04.00.120.12

1.251.25

9696

3232

3333

00

1515



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





1111

50%50%

45%45%

5%5%

Platelets

MPVPlateletcrit

8,0008,000

660.000.0055

Case 20AYED

14 Years

FeverPallorBleedingAcellular marrow

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

4.04.00.120.12

1.251.25

9696

3232

3333

00

1515



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





1111

50%50%

45%45%

5%5%

Platelets

MPVPlateletcrit

8,0008,000

660.000.0055

Case 20AYED

14 Years

FeverPallorBleedingAcellular marrow

APLASTIC ANEMIA

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.230.23

2.92.9

8080

2828

3434

0.20.2

1212



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





8.08.0

68%68%

30%30%

10%10%

2%2%

Platelets

MPVPlateletcrit

320,00320,0000

770.22%0.22%

Case 21OMAR

28 Years

Rheumatoid arthritisESR 85 mm/hrLow Serum iron & TIBCNo response to iron

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.230.23

2.92.9

8080

2828

3434

0.20.2

1212



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





8.08.0

68%68%

30%30%

10%10%

2%2%

Platelets

MPVPlateletcrit

320,00320,0000

770.22%0.22%

Case 21OMAR

28 Years

Rheumatoid arthritisESR 85 mm/hrLow Serum iron & TIBCNo response to iron

ACD

“Anemia of Chronic Disorders”

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.58.50.280.28

2.92.9

9898

3030

3030

11

1212



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





8080

2%2%

5%5%

13%13%

80%80%

Platelets

MPVPlateletcrit

20,0020,0000

550.01%0.01%

Case 22KHALID

30 Years

FeverPallorLymphadenopathyGum hypertrophyMarrow & Blood are full of Blasts positive for non-specific esterase

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.58.50.280.28

2.92.9

9898

3030

3030

11

1212



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





8080

2%2%

5%5%

13%13%

80%80%

Platelets

MPVPlateletcrit

20,0020,0000

550.01%0.01%

Case 22KHALID

30 Years

FeverPallorLymphadenopathyGum hypertrophyMarrow & Blood are full of Blasts positive for non-specific esterase

AML

“M5”

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

12.012.00.400.40

4.54.5

8989

2727

3030

22



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





1010

55%55%

40%40%

5%5%

Platelets

MPVPlateletcrit

180,00180,0000

770.12%0.12%

Case 23MOH’D5 Years

Black SaudiMaxillary Bone swellingNormal marrow & smear

Lesion biopsy: starry-skyLymphoproliferativedisease

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

12.012.00.400.40

4.54.5

8989

2727

3030

22



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





1010

55%55%

40%40%

5%5%

Platelets

MPVPlateletcrit

180,00180,0000

770.12%0.12%

Case 23MOH’D5 Years

Black SaudiMaxillary Bone swellingNormal marrow & smear

Lesion biopsy: starry-skyLymphoproliferativedisease

Burkitt’s

Lymphoma

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.00.340.34

3.83.8

9090

2929

3232

1.21.2

1414



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





8.08.0

60%60%

35%35%

5%5%

Platelets

MPVPlateletcrit

150,00150,0000

77

0.1%0.1%

Case 24JOAN

60 Years

HeadacheBlurred vision

Marrow: Full of Lymphocytes, LPC & Plasma CellsSmear: RouleauxIgM = 10 gm/L

No osteolytic lesionsR/ EPO

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.00.340.34

3.83.8

9090

2929

3232

1.21.2

1414



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





8.08.0

60%60%

35%35%

5%5%

Platelets

MPVPlateletcrit

150,00150,0000

77

0.1%0.1%

Case 24JOAN

60 Years

HeadacheBlurred vision

Marrow: Full of Lymphocytes, LPC & Plasma CellsSmear: RouleauxIgM = 10 gm/L

No osteolytic lesionsR/ EPO Waldenstrom’s

Macroglobulinemia

THANK YOU

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %



MonocytesMonocytes


BasophilsBasophils

Blasts:Blasts:





Platelets

MPVPlateletcrit

Flow CytometryFlow Cytometry

NORMAL BLOOD VALUES. SHEIKHA NORMAL HEMATOLOGICAL VALUES.

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