LEUCOPOYESIS

Lic.Heberto Estrada.

Aspectos generales de la hemopoyesis

La hemopoyesis ocurre a travs de distintos factores que deben de conjugarse adecuadamente.

Mdula sea funcional Clulas madres funcionales Microambiente inductor hematopoytico Factores estimulantes y citoquinas.

Clulas germinales pluripotentes

Denominadas totipotenciales, tronco comn, stem cells. Caractersticas: capacidad de autorrenovarse y de diferenciarse. Existe tambin una clula madre de fibroblastos. Presentan algunos marcadores inespecficos.

Factores estimulantes y citoquinas

Al igual que lo sucedido con las clulas madre, los diferentes factores estimulantes actan a nivel de diversos pasos de la hemopoyesis. Estos factores son producidos por diversos componentes como clulas , linfocitos, monocitos, fibroblastos, clulas endoteliales, granulocitos maduros, etc.

Factores estimulantes y citoquinas

Comprenden un grupo de glicoproteinas con PM que oscilan entre 17500-45000. Hay factores denominados panhemopoyetinas , ya que actan en etapas. Otros como Epo una accin limitada a determinada progenie celular.

Factores estimulantes y citoquinas

Panhemopoyetinas: IL1, IL3, Hemopoyetinas de accin especfica:

IL4, IL5, I Eritropoyetina

Actividad biolgica de los factores estimulantes

IL2: Linfocito B* y T IL4: basfilos y mastocitos*, linfocito B y T, granulocitos, megacariocitos, eosinfilos, monocitos IL5: eosinfilos*, linfocitos T y B(-) IL1 y 3: todas las lneas a partir de la stem IL6 y trombopoyetina: megacariocitos.

Utilidad de los factores de crecimiento

se utilizan en pacientes con neoplasias y en neutropenias. Su utilidad principal es acortar los periodos de recuperacin post quimioterapia. Se contrapone al efecto mielotxico de la quimioterpia, y permite poder utilizar protocolos ms agresivos.

Fase sangunea: fraccin circulante y una marginal. Fase tisular: En trminos generales los granulocitos viven en MO unos 14 das, la etapa entre blasto y mielocito tarda unos 8 dias, de mielocito a neutrfilo unos 7 das, en circulacin 7 das y en tejidos 1-2 das.

La principal prdida de granulocitos ocurre en el sistema gastrointestinal. Algo se pierde en tejidos. La muerte ocurre por fragmentacin o por fagocitosis. Los granulocitos salen de MO y pasan a tejidos por el mismo mecanismo.

Funcin del neutrfilo

Capacidad mtil (a partir del mieloblasto). La velocidad se incrementa al madurar la clula. Migracin: respuesta a quimiotaxinas , linfoquinas, complemento (C3a, C5a). Acitividad fagoctica y microbicida.

Mecanismos de muerte microbiana

Oxgeno dependiente:
mieloperoxidasa H 2O2} Oxgeno . Estos mecanismos posiblemente involucran la en la pared bacteriana

Mecanismos independientes de oxgeno acidez en vacuola fagoctica (pH menor a 3) lisozima Lactoferrina: efecto bacteriosttico Protenas catinicas, cido resistentes, termoestables: actividad de quimiotripsina.

Bioqumica

Sntesis de protenas, cido lctico, lpidos, nucletidos y cidos nuclicos. Dependen de gliclisis. El PMN maduro posee pocas mitocondrias. Ciclo de Krebs es menos importante.

Eosinfilos

Se producen en MO. Vida media 7-12 hrs en sp. La vida total es de 8-12 das. Sus niveles estn influenciados por hormonas: adrenocorticoesteroides que reducen sus niveles. Sus niveles se incrementan con la histamina. Se favorece la liberacin y produccin. Funcin efectora: parsitos y rx alrgicas.

Basfilos

Poseen grnulos ricos en histamina, esterasas, mieloperoxidasa.sulfato, dermatin-sulfato y heparin-sulfato. Expresa receptores para IgG, , e IgE. La unin de IgE causa degranulacin y liberacin de histamina Prevencin en la coagulacin de tejidos. Poseen cido hialurnico y serotonina.

Definicin: Incremento del nmero de bandas neutrfilas y presencia reducida de neutrfilos maduros en sangre perifrica.

Desviacin a la izquierda

Ocurrencia: normalmente no estan presentes

Comentario: Marcada desviacin a la izquierda en la granulopoyesis. Se aprecia anisocitosis de los eritrocitos y plaquetas sin grnulos.

Tincin: MGG Magnificacin: x 1000 Magnificacin:

1. Segmentado neutrfilo 2. Banda neutrfila 3. Mielocito neutrfilo 4. Promielocito 5. Eosinfilo 6. Monocito

MIELOBLASTO

MYELOBLASTS
Tamao celular: 15 - 25

Forma celular: ovalada, algunas veces redondo Color de citoplasma: Azul, sin halo perinuclear visible o con extenso haro perinuclear Grnulos: citoplasma agranular o escasos y finos grnulos azurfilos Forma nucleolar: usualmente ovalada, algunas veces irregular y raramente redondo Tipo de cromatina: fina con apariencia reticular Relacin Ncleo/citoplasma: Alta Nuclelo: visible, mediano o de gran tamao 1 a 4; mayor que la cromatina Ocurrencia: Sangre perifrica: ausencia Mdula sea: < 5%

Size of the cell: 15 - 25

MYELOBLASTS

Shape of the cell: oval, sometimes round Colour of cytoplasm: blue, without distinct perinuclear halo or with extended perinuclear halo Granularity: nongranular cytoplasm or a few thick azurophilic granules Nucleus' shape: usually oval, sometimes irregular, rarely round Type of chromatin: fine, with reticular appearance Nuclear/cytoplasmic ratio: high or relatively high Nucleoli: visible, medium or large size 1 to 4; brighter than chromatin Occurrence: blood: not present marrow: < 5%

MYELOBLASTS
Size of the cell: 15 - 25

Shape of the cell: oval, sometimes round Colour of cytoplasm: blue, without distinct perinuclear halo or with extended perinuclear halo Granularity: nongranular cytoplasm or a few thick azurophilic granules Nucleus' shape: usually oval, sometimes irregular, rarely round Type of chromatin: fine, with reticular appearance Nuclear/cytoplasmic ratio: high or relatively high Nucleoli: visible, medium or large size 1 to 4; brighter than chromatin Occurrence: blood: not present blood: marrow: < 5% marrow:

PROMYELOCYTES
Size of the cell: 15 - 30

Shape of the cell: oval or round Colour of cytoplasm: light-blue, with distinct halo Granularity: thick, azurophilic abundant or very abundant Nucleus' shape: oval Type of chromatin: start of condensation Nuclear/cytoplasmic ratio: moderate, low or ratio: very low Nucleoli: visible, medium or large size, brighter than chromatin, 1-2. Sometimes not visible. Occurrence: blood: not present marrow: < 5 %

PROMYELOCYTES
Size of the cell: 15 - 30

Shape of the cell: oval or round Colour of cytoplasm: light-blue, with distinct halo Granularity: thick, azurophilic abundant or very abundant Nucleus' shape: oval Type of chromatin: start of condensation Nuclear/cytoplasmic ratio: moderate, low or very low Nucleoli: visible, medium or large size, brighter than chromatin, 1-2. Sometimes not visible. Occurrence: blood: not present marrow: < 5 %

PROMYELOCYTES
Size of the cell: 15 - 30 m Shape of the cell: oval or round Colour of cytoplasm: light-blue, with distinct halo Granularity: thick, azurophilic abundant or very abundant Nucleus' shape: oval Type of chromatin: start of condensation Nuclear/cytoplasmic ratio: moderate, low or very low Nucleoli: visible, medium or large size, brighter than chromatin, 1-2. Sometimes not visible. Occurrence: blood: not present marrow: < 5 %

Promielocito en sangre

Promielocito en sangre perifrica en anemia megaloblstica. Note el ncleo excntrico y la zona del aparato de Golgi. Adicionalmente observe la anisocitosis y poiquilocitosis de los glbulos rojos.

NEUTROPHILMYELOCYTES
Size of the cell: 15 - 25

Shape of the cell: oval or round Colour of cytoplasm: light-blue or of pale pink colour undiscernible halo Granularity: abundant, thick azurophilic and neutrophilic granulation Nucleus' shape: oval or kidney shaped Type of chromatin: partially condensed Nuclear/cytoplasmic ratio: low or very low Nucleoli: not visible Occurrence: blood: not present marrow: 5 - 20 %

MIELOCITO

NEUTROPHILMYELOCYTES
Size of the cell: 15 - 25

Shape of the cell: oval or round Colour of cytoplasm: light-blue or of pale pink colour undiscernible halo Granularity: abundant, thick azurophilic and neutrophilic granulation Nucleus' shape: oval or kidney shaped Type of chromatin: partially condensed Nuclear/cytoplasmic ratio: low or very low Nucleoli: not visible Occurrence: blood: not present marrow: 5 - 20 %

Eosinfilo y mielocito eosinfilo

Eosinofilo y mielocito eosinfilo en de un paciente con LMC. El citoplasma del mielocito esta cubierto de grnulos de color naranja-ladrillo El mieolocito eosinfilo es normal en M.O. pero es raro en S.P. de individuos sanos. Un esosinfilo trilobulado y otro bilobulado y parcialmente degranulado.

Neutrophil myelocyte in the blood

NEUTROPHILMYELOCYTES
Size of the cell: 15 - 25 m Shape of the cell: oval or round Colour of cytoplasm: light-blue or of pale pink colour undiscernible halo Granularity: abundant, thick azurophilic and neutrophilic granulation Nucleus' shape: oval or kidney shaped Type of chromatin: partially condensed Nuclear/cytoplasmic ratio: low or very low Nucleoli: not visible Occurrence: blood: not present marrow: 5 - 20 %

NEUTROPHILMETAMYELOCYTES
Size of the cell: 14 - 20 m Shape of the cell: oval or round Colour of cytoplasm: pink Granularity: a few azurophilic and neutrophilic, different in number Nucleus' shape: elongated, semicircular Type of chromatin: condensed Nuclear/cytoplasmic ratio: low or very low Nucleoli: not visible Occurrence: blood: not present marrow: 10 - 25 %

Neutrophil metamyelocyte

METAMIELOCITO

NEUTROPHILMETAMYELOCYTES
Size of the cell: 14 - 20 m Shape of the cell: oval or round Colour of cytoplasm: pink Granularity: a few azurophilic and neutrophilic, different in number Nucleus' shape: elongated, semicircular Type of chromatin: condensed Nuclear/cytoplasmic ratio: low or very low Nucleoli: not visible Occurrence: blood: not present marrow: 10 - 25 % marrow:

NEUTROPHILMETAMYELOCYTES
Size of the cell: 14 - 20 m Shape of the cell: oval or round Colour of cytoplasm: pink Granularity: a few azurophilic and neutrophilic, different in number Nucleus' shape: elongated, semicircular Type of chromatin: condensed Nuclear/cytoplasmic ratio: low or very low Nucleoli: not visible Occurrence: blood: not present marrow: 10 - 25 %

BANDNEUTROPHILS
Size of the cell: 14 - 20 m Shape of the cell: oval or round Colour of cytoplasm: pink Granularity: a few azurophilic and neutrophilic, different in number Nucleus' shape: semicircular Type of chromatin: condensed Nuclear/cytoplasmic ratio: low or very low Nucleoli: not visible Occurrence: blood: < 5% marrow: 5 - 20 %

BANDNEUTROPHILS
Size of the cell: 14 - 20 m Shape of the cell: oval or round Colour of cytoplasm: pink Granularity: a few azurophilic and neutrophilic, different in number Nucleus' shape: semicircular Type of chromatin: condensed Nuclear/cytoplasmic ratio: low or very low Nucleoli: not visible Occurrence: blood: < 5% marrow: 5 - 20 %

BANDNEUTROPHILS
Size of the cell: 14 - 20 m Shape of the cell: oval or round Colour of cytoplasm: pink Granularity: a few azurophilic and neutrophilic, different in number Nucleus' shape: semicircular Type of chromatin: condensed Nuclear/cytoplasmic ratio: low or very low Nucleoli: not visible Occurrence: blood: < 5% marrow: 5 - 20 %

BANDNEUTROPHILS
Size of the cell: 14 - 20 m Shape of the cell: oval or round Colour of cytoplasm: pink Granularity: a few azurophilic and neutrophilic, different in number Nucleus' shape: semicircular Type of chromatin: condensed Nuclear/cytoplasmic ratio: low or very low Nucleoli: not visible Occurrence: blood: < 5% marrow: 5 - 20 %

BANDNEUTROPHILS
Size of the cell: 14 - 20 m Shape of the cell: oval or round Colour of cytoplasm: pink Granularity: a few azurophilic and neutrophilic, different in number Nucleus' shape: semicircular Type of chromatin: condensed Nuclear/cytoplasmic ratio: low or very low Nucleoli: not visible Occurrence: blood: < 5% marrow: 5 - 20 %

Band cell
.

BANDNEUTROPHILS
Size of the cell: 14 - 20 m Shape of the cell: oval or round Colour of cytoplasm: pink Granularity: a few azurophilic and neutrophilic, different in number Nucleus' shape: semicircular Type of chromatin: condensed Nuclear/cytoplasmic ratio: low or very low Nucleoli: not visible Occurrence: blood: < 5% marrow: 5 - 20 %

SEGMENTEDNEUTROPHILS
Size of the cell: 14 - 20 m 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 %

SEGMENTEDNEUTROPHILS
Size of the cell: 14 - 20 m 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 %

SEGMENTEDNEUTROPHILS
Size of the cell: 14 - 20

Shape of the cell: oval or round Colour of cytoplasm: pink Granularity: a few azurophilic and neutrophilic, different in number granulation Nucleus' shape: lobulated (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 %

SEGMENTEDNEUTROPHILS
Size of the cell: 14 - 20

Shape of the cell: oval or round Colour of cytoplasm: pink Granularity: a few azurophilic and neutrophilic, different in number granulation Nucleus' shape: lobulated (normally shape: 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 %

NEUTROPHILS-TOXICGRANULATION
Granularity: thick granules, more eosinophilic stained than typical neutrophilic granularity. Single granules with a tendency to aggregate.

Occurrence in blood: normally not present

NEUTROPHILS-TOXICGRANULATION
Granularity: thick granules, more eosinophilic stained than typical neutrophilic granularity. Single granules with a tendency to aggregate.

Occurrence in blood: normally not present

Toxic granulation and neutrophil vacuolation indicator of bacterial infection.

Toxic granulation, neutrophil vacuolation .

NEUTROPHILS-LEFTSHIFT
Definition: Increased number of the band neutrophils or presence of less mature neutrophils in blood.

Occurrence: normally not present

A hypogranular neutrophil

AGRANULARNEUTROPHILS

Occurrence in blood: normally not present

Staining: MGG

AGRANULARNEUTROPHILS

Occurrence in blood: normally not present

AGRANULARNEUTROPHILS

Occurrence in blood: normally not present

Comment: Granulesless segmented neutrophil leucocyte. Also anisocytosis of erythrocytes.

Staining: MGG

NEUTROPHILS-PELGER-HUETANOMALY
Nucleus shape: All segmented neutrophils have stabforms or bisegmented nucleous. This anomaly occurs also in eosinophilic leucocytes. The anomaly is of no clinical relevance. The neutrophil leucocyte has normal function.

Comment: All three neutrophils have form of bands. Their nuclei

Staining: MGG

Hypersegmented neutrophil
A hypersegmented neutrophil in a patient with megaloblastic anaemia.

Macropolycytes
Macropolycytes in a patient with myelodysplastic syndrome.

NEUTROPHILS-LEFTSHIFT
Definition: Increased number of the band neutrophils or presence of less mature neutrophils in blood.

Occurrence: normally not present

NEUTROPHILS-LEFTSHIFT
Definition: Increased number of the band neutrophils or presence of less mature neutrophils in blood.

Occurrence: normally not present

NEUTROPHILS-VACUOLISATION

Occurrence: normal mature neutrophil leucocytes may contain single small vacuoles in cytoplasm

Comment: Distinct vacuoles changes in the neutrophilic leucocytes. Two target cells and one ovalocyte are present.

Staining: MGG Magnification: x 1000

NEUTROPHILS-VACUOLISATION

Occurrence: normal mature neutrophil leucocytes may contain single small vacuoles in cytoplasm

Comment: Small vacuoles in a neutrophil leucocyte with fine neutrophilic granulation. Staining: MGG

EOSINOPHILICPROMYELOCYTES
Size of the cell: 15 - 30 m Shape of the cell: oval or round Colour of cytoplasm: lightblue with distinct halo, covered by eosinophilic granules Granularity: very abundant, particularly eosinophilic granules; sometimes azurophilic granules are visible. Nucleus' shape: oval Type of chromatin: start of condensation Nuclear/cytoplasmic ratio: low or very low Nucleoli: visible, medium or large size, brighter than chromatin, 1-2, sometimes undiscernible Occurrence blood: not present marrow: < 1 %

MATUREEOSINOPHILS

Size of the cell: 15 - 25 m 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 %

MATUREEOSINOPHILS
Size of the cell: 15 - 25 m Shape of the cell: oval or round Colour of cytoplasm: pale, covered cytoplasm: 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

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 Occurrence: blood: < 1 % blood: marrow: < 1 %

BASOPHILS

Size of the cell: 12 - 18 m Shape of the cell: round or oval Colour of cytoplasm: light-pink, mostly covered by granules and nucleus Granularity: very dark, basophilic, Granularity: 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 Occurrence: blood: < 1 % marrow: < 1 %

LINFOPOYESIS

Linfocitos

Se produce en el tejido linfoide de MO, timo, bazo y ganglios linfticos. Su funcin la realizan en un intercambio constante entre sangre perifrica y tejidos. Los linfocitos dejan la circulacin en los espacios linfoides tisulares, llegan a conductos linfticos, pasan por varios ganglios linfticos y retornan a la circulacin por el ducto torxico.

Esta recirculacin permite, entre otros a los LT ponerse en contacto con diversos antgenos. Sin esta recirculacin la capacidad de respuesta inmune sera muy pobre, ya que se limitara a los linfocitos locales. Sobrevida: una poblacin vive 10-20 das (1/3 LB) Meses o aos: principalmente LT

Prdida de linfocitos

Transforman en otras clulas por estimulacin. Prdida en tracto digestivo Prdida pulmonar Fagocitosis: a nivel de ganglios linfticos, folculos, y tejidos.

Linfocito B

Responsable de la inmunidad humoral. Presenta Ig de superficie Sin receptores para eritrocitos de carnero Reconocimiento antignico Diferenciacin a serie plasmactica

LYMPHOBLASTS
Size of the cell: 12 - 18 m Shape of the cell: round, sometimes oval Colour of cytoplasm: blue, usually dark Granularity: not present Nucleus' shape: round Type of chromatin: homogenous Nuclear/cytoplasmic ratio: high Nucleoli: visible, small or medium size, brighter than chromatin, 1 to 2. Occurrence in blood: not present marrow: < 1 %

LYMPHOBLASTS
Size of the cell: 12 - 18 m Shape of the cell: round, sometimes oval Colour of cytoplasm: blue, usually dark Granularity: not present Nucleus' shape: round Type of chromatin: homogenous Nuclear/cytoplasmic ratio: high Nucleoli: visible, small or medium size, brighter than chromatin, 1 to 2. Occurrence: blood: not present marrow: < 1 % marrow:

LINFOBLASTO

LINFOBLASTO

Linfocito T

Inmunidad celular Receptor antignico del LT (TCR) CD8 (citotxico)/CD4(cooperadores)

LYMPHOCYTES
Size of the cell: 10 - 15 m Shape of the cell: round, sometimes oval Colour of cytoplasm: blue Granularity: not present Nucleus' shape: round or slightly oval Type of chromatin: homogenous, condensed Nuclear/cytoplasmic ratio: high or very high Nucleoli: invisible, sometimes hardly visible, small, single nucleous Occurrence: blood: 25 - 40 % marrow: 5 - 20 %

LYMPHOCYTES
Size of the cell: 10 - 15 cell: m Shape of the cell: round, sometimes oval Colour of cytoplasm: blue Granularity: not present Nucleus' shape: round or slightly oval Type of chromatin: homogenous, condensed Nuclear/cytoplasmic ratio: high or very high Nucleoli: invisible, sometimes hardly visible, small, single nucleous Occurrence: blood: 25 - 40 % marrow: 5 - 20 %

LYMPHOCYTES
Size of the cell: 10 - 15 m Shape of the cell: round, sometimes oval Colour of cytoplasm: blue Granularity: not present Nucleus' shape: round or slightly oval Type of chromatin: homogenous, condensed Nuclear/cytoplasmic ratio: high or very high Nucleoli: invisible, sometimes hardly visible, small, single nucleous Occurrence: blood: 25 - 40 % marrow: 5 - 20 %

LYMPHOCYTES
Size of the cell: 10 - 15 m Shape of the cell: round, sometimes oval Colour of cytoplasm: blue Granularity: not present Nucleus' shape: round or slightly oval Type of chromatin: homogenous, condensed Nuclear/cytoplasmic ratio: high or very high Nucleoli: invisible, sometimes hardly visible, small, single nucleous Occurrence: blood: 25 - 40 % marrow: 5 - 20 %

LARGEGRANULARLYMPHOCYTES
Size of the cell: 15 - 25 m 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 %

LARGEGRANULARLYMPHOCYTES
Size of the cell: 15 - 25 m 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 %

Linfocito con grnulos

Normal large lymphocyte .

LYMPHOPLASMOCYTES
Size of the cell: 10 - 20 m Shape of the cell: oval Colour of cytoplasm: deep blue Granularity: none Nucleus' shape: oval or irregular Type of chromatin: clumped Nuclear/cytoplasmic ratio: moderate or low Nucleoli: invisible or hardly visible, single Occurrence blood: < 2 %

PLASMOCYTES
Size of the cell: 15 - 20 Shape of the cell: oval Colour of cytoplasm: deep-blue with big perinuclear halo, sometimes single vacuole is present Granularity: none Nucleus' shape: round Type of chromatin: condensed Nuclear/cytoplasmic ratio: low Nucleoli: not visible Occurrence: blood: not present marrow: < 3%

PLASMOCYTES
Size of the cell: 15 - 20 Shape of the cell: oval cell: Colour of cytoplasm: deep-blue with big perinuclear halo, sometimes single vacuole is present Granularity: none Nucleus' shape: round Type of chromatin: condensed Nuclear/cytoplasmic ratio: low Nucleoli: not visible Occurrence: blood: not present marrow: < 3%

PLASMOCYTES
Size of the cell: 15 - 20 m Shape of the cell: oval Colour of cytoplasm: deep-blue with big perinuclear halo, sometimes single vacuole is present Granularity: none Nucleus' shape: round Type of chromatin: condensed Nuclear/cytoplasmic ratio: low Nucleoli: not visible Occurrence: blood: not present marrow: < 3%

Plasma cell
Plasma cells may appear in the blood as a reaction to infections or other immunological stimuli. They resemble normal bone marrow plasma cells. They are larger than a normal small lymphocyte and have basophilic cytoplasm, an eccentric nucleus and a paler Golgi zone adjacent to the nucleus.

Vacuolated lymphocyte
A vacuolated lymphocyte in I cell disease. Vacuolated lymphocytes are seen in a number of inherited metabolic disorders. They are also occasionally seen in reactive conditions or in lymphomas

LEUCEMIAS