1.

Sahli’s Haemoglobinometer

 Used for estimation of hemoglobin by the acid hematin method.

 Normal Hb: Male 13–17 g/dL, Female 12–15 g/dL.

2. Neubauer’s Counting Chamber

 Used for manual counting of RBCs,

WBCs, and platelets.

 Contains a ruled grid of known

dimensions.

3. Hb Pipette

Used to collect 20 µL of blood for

Sahli's method.

 Has a mark at 20 mm³ (20 µL).

4. EDTA Tube (Purple Top)5

  Anticoagulant: Ethylene Diamine Tetra Acetic Acid (EDTA).
 Used for CBC, peripheral smear, and
hematological tests.
5. Sodium Citrate Tube (Blue Top)
 Anticoagulant used for coagulation studies.
 Used for PT, APTT, and ESR (Westergren
method).
6. Plain Vacutainer (Red Top)
 Contains no anticoagulant.
 Used for serum collection and biochemical
investigations.
7. Heparin Tube (Green Top)
 Contains heparin anticoagulant.

 Used for plasma chemistry and blood gas analysis.

8. Blood Collection Bag

 Used for collection and storage of donor blood.

 Contains anticoagulant-preservative solution (CPDA-

1).

9. Lumbar Puncture Needle

 Used to collect cerebrospinal fluid (CSF).

 Inserted between L3–L4 or L4–L5 vertebrae.

10. Liver Biopsy Needle

Used to obtain liver tissue for histopathology.

  Helps diagnose cirrhosis, hepatitis, and liver tumors.

11. Bone Marrow Aspiration Needle

 Used to obtain bone marrow aspirate.

 Common sites: sternum and posterior iliac

crest.

12. Wintrobe’s Tube

 Used for ESR and packed cell volume (PCV).

 Graduated from 0–100 mm.

13. Westergren’s Tube

 Gold standard
method for ESR
estimation.

 Tube length is
approximately 300
mm.

14. Urinometer

 Evaluation of hydration status.

 Assessment of renal function and urinary

concentration.

15. RBC Pipette

 Has a red bead in

the bulb.

 Used for dilution of blood for RBC counting (1:200 dilution).

16. WBC Pipette

 Has a white bead in the bulb.

 Used for dilution of blood for WBC

counting (1:20 dilution).

Slide Two Important Points

Acute Myeloid • Presence of myeloblasts in peripheral
Leukaemia (AML) blood/bone marrow. • Auer rods may be seen
in blast cells.

Chronic Lymphocytic • Marked lymphocytosis with mature

Leukaemia (CLL) lymphocytes. • Smudge (basket) cells are
characteristic.

Atherosclerosis • Intimal fibrofatty plaques narrow the

arterial lumen. • Cholesterol clefts and
fibrous cap are seen microscopically.

Lobar Pneumonia • Consolidation involving an entire lobe of the

lung. • Alveoli filled with neutrophils and
fibrin exudate.

Tuberculosis Lung • Caseating granulomas with central

necrosis. • Epithelioid cells and Langhans
giant cells present.

Pleomorphic • Most common benign salivary gland tumor.

Adenoma • Mixed epithelial and mesenchymal
(myxoid/chondroid) components.

Adenocarcinoma of • Malignant gland formation invading the

Colon bowel wall. • Tumor cells produce mucin.

Capillary • Benign tumor composed of numerous

Haemangioma capillary-sized vessels. • Vessels lined by
flattened endothelial cells.

Normoblastic • RBCs have normal size and normal

Normocytic Blood haemoglobinization. • Seen in healthy
Picture (NNBP) individuals and acute blood loss.

Cirrhosis • Regenerating nodules surrounded by

fibrous septa. • Distortion of normal liver
architecture.

Fatty Liver (Hepatic • Hepatocytes contain fat vacuoles. • Liver

Steatosis) becomes enlarged and yellow.

Eosinophilia • Increased eosinophils with bilobed nuclei. •

Associated with allergy and parasitic
infestations.

Macrocytic Anemia • RBCs are larger than normal (increased

MCV). • Commonly due to vitamin B12 or
 folate deficiency.

Microcytic • Small RBCs with increased central pallor. •

Hypochromic Anemia Most commonly caused by iron deficiency
anemia.

Adenocarcinoma of Colon (Histopathology Slide)

Identification

Adenocarcinoma is the most common malignant tumor of the colon,

arising from the glandular epithelium of the colonic mucosa.

Microscopic Features

1. Irregular malignant glands

o Tumor cells form abnormal glands of varying size and shape.

o Glands infiltrate deep into the bowel wall.

2. Cellular atypia

o Enlarged, hyperchromatic nuclei.

o Increased nuclear-cytoplasmic ratio.

o Loss of polarity.

3. Mucin production

o Mucin may be present within gland lumina or inside tumor

cells.

o Some tumors show abundant extracellular mucin.

4. Invasion

o Malignant glands invade muscularis propria and surrounding

stroma.

o Desmoplastic (fibrous) stromal reaction is common.

Gross Features

 Ulceroproliferative or annular ("napkin-ring") growth.

 Right-sided tumors are polypoid and exophytic.

 Left-sided tumors cause constriction and intestinal obstruction.

Risk Factors

 Adenomatous polyps.
  Familial Adenomatous Polyposis (FAP).

 Lynch syndrome.

 Ulcerative colitis.

 High-fat, low-fiber diet.

Clinical Features

 Altered bowel habits.

 Blood in stool.

 Weight loss.

 Iron deficiency anemia.

 Intestinal obstruction (especially left-sided lesions).

Viva Points

 Most common malignant tumor of the large intestine.

 Spreads first to regional lymph nodes and then to the liver via the
portal vein.

 Tumor marker: CEA (Carcinoembryonic Antigen).

Spot Diagnosis Statement

"This slide shows adenocarcinoma of the colon characterized by

infiltrating malignant glands lined by atypical columnar epithelial cells
with hyperchromatic nuclei and mucin production."

Microcytic Hypochromic Anemia (Peripheral Blood Smear)

Identification

Microcytic hypochromic anemia is characterized by small pale red blood

cells due to reduced hemoglobin synthesis.

Microscopic Features

1. Microcytosis

o RBCs are smaller than normal.

o Reduced Mean Corpuscular Volume (MCV).

2. Hypochromia

o Increased central pallor occupying more than one-third of RBC

diameter.
 o Reduced hemoglobin content.

3. Anisocytosis

o Variation in RBC size.

4. Poikilocytosis

o Variation in RBC shape.

o Pencil cells and target cells may be seen.

Common Causes

 Iron deficiency anemia (most common).

 Thalassemia.

 Sideroblastic anemia.

 Anemia of chronic disease (sometimes).

Laboratory Findings

 Decreased Hb.

 Decreased MCV.

 Decreased MCH and MCHC.

 Low serum ferritin in iron deficiency anemia.

Clinical Features

 Pallor.

 Fatigue.

 Weakness.

 Breathlessness.

 Koilonychia (spoon nails) in iron deficiency.

Viva Points

 Most common cause: Iron deficiency anemia.

 Peripheral smear shows microcytic hypochromic RBCs with

increased central pallor.

 Bone marrow iron stores are reduced in iron deficiency anemia.

Spot Diagnosis Statement

"This peripheral blood smear shows microcytic hypochromic anemia

characterized by small red blood cells with increased central pallor,
suggestive of defective hemoglobin synthesis, most commonly due to iron
deficiency."

Examer's Favorite Question

How do you differentiate Microcytic Hypochromic Anemia from

Macrocytic Anemia on a smear?

Microcytic
Feature Macrocytic
Hypochromic

RBC Size Small Large

Hemoglobinizati
Pale Usually normal
on

MCV Decreased Increased

Vitamin B12/Folate
Common Cause Iron deficiency
deficiency

Slide Identification Points (Microscopic

Features)

Acute Myeloid • Numerous myeloblasts present. • Large cells

Leukemia (AML) with high N:C ratio. • Fine chromatin and
prominent nucleoli. • Auer rods may be seen in
cytoplasm.

Chronic Lymphocytic • Marked lymphocytosis. • Predominance of

Leukemia (CLL) small mature lymphocytes. • Dense clumped
chromatin. • Smudge (basket) cells present.

Atherosclerosis • Thickened arterial intima. • Fibrofatty

atheromatous plaque present. • Cholesterol
clefts seen in plaque. • Fibrous cap overlying
lipid core.

Lobar Pneumonia • Alveolar spaces filled with neutrophils. •

Fibrinous exudate within alveoli. • Congested
alveolar septa. • Loss of normal air spaces due
to consolidation.

Tuberculosis Lung • Granuloma formation. • Central caseous

necrosis. • Epithelioid cells surrounding
 necrosis. • Langhans giant cells present.

Pleomorphic • Well-circumscribed tumor. • Duct-like

Adenoma epithelial structures. • Myxoid stroma present.
• Chondroid (cartilage-like) areas seen.

Adenocarcinoma of • Irregular infiltrating malignant glands. •

Colon Hyperchromatic pleomorphic nuclei. • Loss of
normal glandular architecture. • Mucin
secretion may be present.

Capillary • Numerous capillary-sized vascular channels.

Hemangioma • Vessels lined by flattened endothelial cells. •
Lumina filled with RBCs. • Minimal cellular
atypia.

Normoblastic • RBCs of normal size. • Normal central pallor.

Normocytic Blood • Uniform shape and staining. • Normal
Picture (NNBP) leukocyte and platelet morphology.

Cirrhosis • Regenerating hepatocyte nodules. • Broad

fibrous septa separating nodules. • Distorted
liver architecture. • Loss of normal lobular
pattern.

Fatty Liver (Hepatic • Hepatocytes contain clear vacuoles. •

Steatosis) Nucleus pushed to the periphery. • Fat droplets
within cytoplasm. • Preserved liver architecture
in early stages.

Eosinophilia • Increased eosinophils in peripheral smear. •

Bilobed nuclei. • Large coarse eosinophilic
granules. • Eosinophils increased above normal
percentage.

Macrocytic Anemia • Large RBCs (macrocytes). • Increased MCV. •

Macro-ovalocytes may be present. •
Hypersegmented neutrophils may be seen.

Microcytic • Small RBCs (microcytes). • Increased central

Hypochromic pallor. • Hypochromic red cells. • Anisocytosis
Anemia and poikilocytosis may be present.