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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_2768_Библиотеки_им_академика_М_И_Перельмана
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CHAPTER 13 Diseases Affecting Erythrocytes
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HEMOGLOBIN CC DISEASE
127
A
FIGURE 13.13A Hemoglobin CC (arrows) (PB×500).
Peripheral Blood: Polychromasia, target cells, spherocytes, microcytes, intracellular and/or extracellular
rod-shaped crystals possible
ASSOCIATED WITH: Homozygous hemoglobin C (see Figure 11.6)
B
FIGURE 13.13B Hemoglobin CC (PB×1000).
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SECTION 3 Erythrocytes
HEMOGLOBIN SS DISEASE
A
FIGURE 13.14A Hemoglobin SS (PB ×500).
Peripheral Blood: Sickle cells (in crises), target cells, nucleated erythrocytes, schistocytes, Howell-Jolly
bodies, basophilic stippling, Pappenheimer bodies, polychromasia, increased leukocyte count with neutrophilia, thrombocytosis
ASSOCIATED WITH: Homozygous hemoglobin S (see Figure 11.6)
B
FIGURE 13.14B Hemoglobin SS (PB ×1000).
CHAPTER 13 Diseases Affecting Erythrocytes
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HEMOGLOBIN SC DISEASE
129
A
FIGURE 13.15A Hemoglobin SC (PB ×500).
Peripheral Blood: Few sickle cells, target cells, intraerythrocytic crystals; crystalline aggregates of hemoglobin
SC may protrude from the erythrocyte membrane
ASSOCIATED WITH: Hemoglobin SC (see Figure 11.8)
B
FIGURE 13.15B Hemoglobin SC (arrows) (PB ×1000).
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CHAPTER 14
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NUCLEAR AND CYTOPLASMIC
CHANGES IN LEUKOCYTES
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SECTION 4 Leukocytes
HYPOSEGMENTATION OF NEUTROPHILS
A
FIGURE 14.1A Hyposegmentation: peanut-shaped nucleus.
C
B
FIGURE 14.1B Hyposegmentation: bilobed nucleus.
DESCRIPTION: Peanut-shaped, bilobed or
non-segmented, granulocyte nucleus with the
coarse chromatin of a mature cell
ASSOCIATED WITH: Pelger-Hüet anomaly,
pseudo-Pelger-Hüet anomaly
NOTE: Pelger-Hüet anomaly is inherited and
affects the majority of granulocytes. PseudoPelger-Hüet is acquired, affects less than 50%
of granulocytes, and is usually accompanied by
other morphologic indications of malignancy,
such as those seen in myeloproliferative or
myelodysplastic disorders (see Chapter 17,
Myeloproliferative Neoplasms and Chapter 18
Myelodyspastic Syndromes.).
FIGURE 14.1C Non-segmented nucleus.
CHAPTER 14 Nuclear and Cytoplasmic Changes in Leukocytes
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HYPERSEGMENTATION OF NEUTROPHILS
133
A
FIGURE 14.2A Hypersegmented neutrophil.
DESCRIPTION: Six or more lobes in granulocyte nucleus
ASSOCIATED WITH: Megaloblastic anemias, chronic infections, myelodysplastic syndrome; rarely inherited
B
FIGURE 14.2B Hypersegmented neutrophil.
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SECTION 4 Leukocytes
VACUOLATION IN NEUTROPHILS
A
FIGURE 14.3A Vacuoles.
DESCRIPTION: Unstained circular area within the cytoplasm
NUMBER: Few to many
ASSOCIATED WITH: Bacterial or fungal infection, poisoning, burns, chemotherapy, artifact
NOTE: Vacuoles rarely may contain microorganisms or pigment. Vacuoles are seen in normal monocytes
and do not suggest infection.
B
FIGURE 14.3B Vacuoles.
CHAPTER 14 Nuclear and Cytoplasmic Changes in Leukocytes
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DÖHLE BODY
135
A
FIGURE 14.4A Döhle body (arrow).
DESCRIPTION: Gray-blue, variably shaped inclusion in cytoplasm
COMPOSITION: Ribosomal RNA
NUMBER: Single or multiple
ASSOCIATED WITH: Wide range of conditions, including bacterial infection, sepsis, and normal pregnancy
NOTE: May be seen in cells with toxic granulation or on same slide with toxic granulation.
(See Figure 14.5B.)
B
FIGURE 14.4B Döhle body (arrow).
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SECTION 4 Leukocytes
BLUE-GREEN INCLUSION
C
FIGURE 14.4C Blue-green inclusion of neutrophil
(PB ×1000).
(Courtesy George Girgis, [CLS], IU Health.)
D
FIGURE 14.4D Blue-green inclusion of monocyte
(PB ×1000).
(Courtesy George Girgis, [CLS], IU Health.)
DESCRIPTION: Amorphous blue-green granules in cytoplasm of neutrophils
COMPOSITION: Lipid-rich, possibly lipofusion-like material
NUMBER: Single or multiple
ASSOCIATED WITH: Severe liver disease, lactic acidosis, sepsis
NOTE: Also known as the blue-green crystals of death.
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