PATHOLOGY
Practical Exam Reviewer by CLT :
RBC AND WBC
Created by:
Christian Tan
DIAGNOSIS: MICRO ANGIOPATHIC HEMOLYTIC ANEMIA
- Pointer: Fragmented RBC (different sizes and shapes)
Note:
Type of Hemolytic Anemia that resulted from trauma due to
narrow/obstructed vessel that forced RBC to squeeze.
NORMAL PERIPHERAL SMEAR
Note:
1/3 central pallor of the RBC. The size is normal since it is
smaller that WBC, but almost the same size of small
lymphocyte.
DIAGNOSIS: HYPOCHROMIC MICROCYTIC ANEMIA
- There is more than 1/3 of central pallor making the size is a lot
smaller
Diseases: IDA; Thallasemia; Chronic Blood loss; Chronic Diseases
like Renal Problem
DIAGNOSIS: ACUTE MYELOGENOUS LEUKEMIA (AML)
- At least 20% are myeloid blasts cells in BM
- Delicate nuclear chromatin, prominent nucleoli, fine
azurophilic granules (Auer rods: Black circle)
- To differentiate from ALL, the blast cells must show
granules or Auer rods
LESION: TOXIC GRANULES
- Found in severe inflammatory states
- These granules are azurophilic and usually found in promyelocyte,
metamyelocyte, band and segmented stages
- The granules may be hard to be seen in this picture, make sure
that the toxic granules are quite large, aggregate and looks
abnormal(different from Auer rods)
DIAGNOSIS: CHRONIC MYELOGENOUS LEUKEMIA (CML)
- PBS: Mature granulocytes, band forms, metamyelocytes,
myelocyte
- Chronic: Less blast seen (<10%) with platelets increased
- Philadelphia chromosome (t9;22)
- Remember: CML are mixture of mature, immature and less of
blasts like in this slide.
SECTION B
UERMMMC Class 2014
Pathology
1 | 2
DIAGNOSIS: ACUTE LYMPHOBLASTIC LEUKEMIA
DIAGNOSIS: MULTIPLE MYELOMA (RIB)
- PBS: Predominantly lymphoblasts Condensed nuclear chromatin, - Bone Marrow: Hypercellular; predominantly plasma cells
small or absent nucleoli, scanty AGRANULAR basophilic
(>30%)
cytoplasm
- Plasma cells: Eccentric nuclei, perinuclear clearing and
- Acute: Due to predominance of blast cells (>20% of total)
clockface chromatin (some plasma cells are multinucleated
- Remember: AGRANULAR! Blast cells that dont have GRANULES!
and with cytoplasmic droplets
DIAGNOSIS: HODGKINS LYMPHOMA
- Organ: Spleen
- Find this encircled pointed cell (Reed-Sternberg cell), and you can
diagnosed this slide
- RS Cell: Large inclusion-like nucleoli, binucleated with abundant
cytoplasm (Owls eye appearance)
- PATHOGNOMONIC for this lymphoma
DIAGNOSIS: HODGKINS LYMPHOMA
- Organ: Lymph node
- Like in the spleen, find the RS cell
- Lymph node: Diffusely effaced by heterogenous cellular
infiltrate such as granulocytes, plasma cells, lymphocytes and
RS cells
- In this slide, it is quite hard to find a RS Cell; to confirm it, use
HPO.
- It is quite hard to distinguish Spleen from Lymph node
- They may show you RS Cell (DNMS) then ask for diagnosis.
Note:
We didnt include the picture from the LCD, lectures powerpoint nor CDs ppt. Be RESPONSIBLE to study the theoretical part. We
just include here the demo slides that have been provided to us. Thank you Kathy for the pictures =)
Philippians 4:13
I can do all things through Christ who strengthens me.
Proverbs 3:5-6
Trust in the Lord with ALL your heart and lean not on your own understanding; In all your ways acknowledge Him, and He
will make your paths straight
SECTION B
UERMMMC Class 2014
Pathology
2 | 2