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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 22
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MISCELLANEOUS CELLS
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SECTION 5 Miscellaneous
HEMATOLOGIC MANIFESTATIONS OF SYSTEMIC DISORDERS
FIGURE 22.1 Gaucher cell (BM ×1000).
DESCRIPTION: The Gaucher cell is a macrophage 20 to 80 μm in diameter, with one or more small, round to
oval eccentric nuclei; cytoplasm has crumpled tissue-paper appearance; found in bone marrow, spleen, liver,
and other affected tissue. Engulfed material is glucocerebroside
FIGURE 22.2 Niemann-Pick cell (BM ×1000).
DESCRIPTION: The Niemann-Pick cell is a macrophage, 20 to 90 μm in diameter, with a small eccentric
nucleus and foamy cytoplasm. It is found in bone marrow and lymphoid tissue. The peripheral blood
of patients with Niemann-Pick disease may exhibit vacuolated lymphocytes. Engulfed material is
sphingomyelin
CHAPTER 22 Miscellaneous Cells
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FIGURE 22.3 Lymphocyte from Sanlippo syndrome (PB×1000).
DESCRIPTION: Peripheral blood lymphocytes containing azurophilic granules occasionally surrounded by halos
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ASSOCIATED WITH: Mucopolysaccharide storage disorders
FIGURE 22.4 Alder-Reilly anomaly (PB×1000).
(Courtesy Dennis P. O’Malley, MD, Clarient, Inc., Aliso Viejo, CA.)
DESCRIPTION: Deep purple to lilac granules difcult to distinguish from toxic granulation; occur in
neutrophils and occasionally eosinophils and basophils
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SECTION 5 Miscellaneous
FIGURE 22.5 May-Hegglin anomaly with Döhle-like body (arrow) (PB ×1000).
DESCRIPTION: Characterized by thrombocytopenia with large platelets and large basophilic inclusions
resembling Döhle bodies in granulocytes and monocytes with the absence of toxic granulation
NOTE: These inclusions are sporadically visible by light microscopy, but always detectable by electron
microscopy. The ultrastructure varies from that of Döhle bodies.
CHAPTER 22 Miscellaneous Cells
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CHEDIAK-HIGASHI SYNDROME
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A
FIGURE 22.6A Chédiak-Higashi anomaly neutrophil with
granules (PB ×1000).
C
B
FIGURE 22.6B Chédiak-Higashi anomaly eosinophil
with granules (PB ×1000).
D
FIGURE 22.6C Chédiak-Higashi anomaly lymphocyte with
granule (PB×1000).
DESCRIPTION: Large gray-blue granules in the cytoplasm of many granulocytes. Monocytes, lymphocytes,
and eosinophils may contain large red-purple granules
FIGURE 22.6D Chédiak-Higashi anomaly monocyte with
granules (PB ×1000).
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SECTION 5 Miscellaneous
OTHER CELLS SEEN IN BONE MARROW
FIGURE 22.7 Fat/adipose cell (BM×500).
DESCRIPTION: Large round cell, 50 to 80 μm; cytoplasm lled with one or several large fat vacuoles,
colorless to pale blue; nucleus small, round to oval, and eccentric; chromatin coarse; nucleoli seldom seen
DESCRIPTION: Large cell (12 to 25 μm) with round to oval nucleus; cytoplasm is colorless to lavender with
many dark blue to black granules that may partially obscure the nucleus. Constitutes less than 1% of bone
marrow cells. Increased numbers may be seen in allergic inammation and anaphylaxis
FIGURE 22.8 Mast cell (BM ×1000).
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A
FIGURE 22.9A Mitosis (BM ×1000).
B
FIGURE 22.9B Mitosis (BM ×1000).
DESCRIPTION: Mitotic gure: a cell that is dividing. Increased numbers may be seen in neoplastic disorders
A
B
FIGURE 22.10A Endothelial cells lining a blood vessel
(BM, original magnication ×500).
DESCRIPTION: Large, elongated cells, 20 to 30 μm; one oval nucleus with dense chromatin; nucleoli not
visible; function is to line blood vessels; rarely seen in peripheral blood
FIGURE 22.10B Endothelial cells (BM, original
magnication ×1000).
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SECTION 5 Miscellaneous
FIGURE 22.11 Osteoblasts (BM, original magnication ×1000).
DESCRIPTION: Large comet or tadpole-shaped cell, 30 μm; single, round, eccentrically placed nucleus, may
be partially extruded; abundant cytoplasm with chromophobic area located away from nucleus; often
appears in groups; function in synthesis of bone
NOTE: May be confused with plasma cells (see Figure 19.4B).
FIGURE 22.12 Osteoclast (BM, original magnication ×1000).
DESCRIPTION: Very large (>100μm), multinucleated with irregularly shaped rufed border; nuclei are round
to oval, separate and distinct with little variation in nuclear size; cytoplasm may vary from slightly basophilic to very acidophilic; coarse granules may be present; osteoclasts function in the resorption of bone
NOTE: May be confused with megakaryocytes (see Figure 4.6A).
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A
FIGURE 22.13A Metastatic tumor (BM×100).
DESCRIPTION: Tumor cell clusters may be recognized during the ×100 scan of bone marrow, especially at or
near the edge of the coverslip or glass slide. Characteristics of the tumor cells are more easily observed
at ×1000 magnication. Cells are variable in size and shape within the same tumor clump. Nuclei vary in
size and staining characteristics. Nucleoli are usually visible. It is sometimes difcult to distinguish one
cell from another because of “molding” of cells
B
FIGURE 22.13B Metastatic tumor (arrow) (BM×500).
DESCRIPTION: Macrophage 20 to 60 μm in diameter with eccentric nucleus; cytoplasm contains varying
numbers of prominent blue-green granules; may be seen in diseases with rapid cell turnover, such as
myeloproliferative neoplasms
FIGURE 22.14 Sea blue histiocyte (BM ×1000).
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SECTION 5 Miscellaneous
FIGURE 22.15 Erythrophagocytosis (BM ×1000).
DESCRIPTION: Monocyte or macrophage with engulfed erythrocyte at arrow; may be seen in some
transfusion reactions
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