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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 3 Erythrocyte Maturation
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POLYCHROMATIC ERYTHROCYTE
Diffusely Basohilic Erythrocyte
Reticulocyte
27
A
FIGURE 3.10A Polychromatic erythrocyte. Sometimes
appears “lumpy” and larger than mature red blood
cells. Slight gray-blue color persists (arrows) while the
cell attains full hemoglobinization.
SIZE: 8 to 8.5 μm
NUCLEUS: Absent
Nucleoli: NA
Chromatin NA
CYTOPLASM: Color is slightly more blue/purple than the mature erythrocyte
N:C RATIO: NA
REFERENCE INTERVAL:
Bone Marrow: 1%
Peripheral Blood: 0.5% to 2.0%
NOTE: When stained with supravital stain (e.g., new methylene blue), polychromatic erythrocytes appear
as reticulocytes (contain precipitated ribosomal material; see Figure 12.5A).
B
FIGURE 3.10B Scanning electron micrograph of poly-
chromatic erythrocyte (×5000). Note that the reticulocyte is a very deformable cell, giving it a “lumpy”
appearance by scanning electron microscopy.
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SECTION 2 Hematopoiesis
S
T
E
M
Multipotent
hematopoietic stem cell
P
R
O
G
E
N
I
T
O
R
P
R
E
C
U
R
S
O
R
Common myeloid
progenitor
Megakaryocyteerythrocyte progenitor
Pronormoblast
Basophilic
normoblast
Polychromatic
normoblast
Orthochromic
normoblast
P
E
R
B
I
L
P
O
H
O
E
D
R
A
L
FIGURE 3.11 Erythrocyte sequence: erythrocyte.
Polychromatic
erythrocyte
Erythrocyte
ERYTHROCYTE
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CHApTER 3 Erythrocyte Maturation
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A
FIGURE 3.12A Erythrocyte. The mature erythrocyte
has lost the blue-gray color and is salmon colored as
hemoglobinization is complete.
SIZE: 7 to 8 μm
NUCLEUS: Absent
Nucleoli: NA
Chromatin: NA
CYTOPLASM: Salmon with central pallor of about one-third of the diameter of the cell
N:C RATIO: NA
REFERENCE INTERVAL
Bone Marrow: NA
Peripheral Blood :Predominant cell type
B
FIGURE 3.12B Scanning electron micrograph of erythro-
cyte (×2500).
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SECTION 2 Hematopoiesis
S
T
E
Multipotent
hematopoietic stem cell
M
P
R
O
Common myeloid
progenitor
G
E
N
I
T
O
Megakaryocyteerythrocyte progenitor
R
Pronormoblast
A
Basophilic
P
R
E
normoblast
B
C
U
R
S
O
R
Polychromatic
normoblast
C
FIGURE 3.13 Erythrocyte sequence with: (A) pronormoblast; (B) basophilic normoblast; (C) polychro-
matic normoblast; (D) orthochromic normoblast; (E) polychromatic erythrocyte; and (F) erythrocyte.
Orthochromic
normoblast
D
P
E
R
B
I
L
P
O
H
O
E
D
R
Polychromatic
erythrocyte
(reticulocyte)
E
Erythrocyte
A
L
F
CHAPTER 4
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MEGAKARYOCYTE MATURATION
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SECTION 2 Hematopoiesis
latelets arise from the megakaryocyte. Megakaryocytes are among the largest cells in the
body and mature by a unique process called endomitosis. In endomitosis, the nucleus is
P
duplicated but there is no cell division, resulting in a polyploid cell. Megakaryocyte nuclei
may have from 2 to 32 lobes and in unusual cases may have up to 64 lobes. Megakaryocytes
develop copious cytoplasm, which differentiates into platelets. Platelets have several types
of granules that can be visualized by electron microscopy. The granules are highly specialized. Refer to a hematology textbook, such as Rodak’s Hematology: Clinical Principles and
Applications, sixth edition, for further discussion.
S
T
E
M
P
R
O
G
E
N
I
T
O
R
P
R
E
C
U
R
S
O
R
Multipotent
hematopoietic stem cell
Common myeloid
progenitor
Megakaryocyte-erythrocyte
progenitor
Megakaryoblast
MK-I
Promegakaryocyte
MK-II
Megakaryocyte
MK-III
P
E
R
B
I
L
P
O
H
O
E
D
R
A
L
FIGURE 4.1 Megakaryocyte sequence: megakaryoblast (MK-I).
Platelets
ChApTER 4 Megakaryocyte Maturation
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MEGAKARYOBLAST (MK-I)
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A
FIGURE 4.2A Megakaryoblast (MK-I): bone marrow (×1000).
SIZE: 10 to 24 μm
NUCLEUS: Round
Nucleoli: 2 to 6
Chromatin: Homogeneous, loosely organized
Nucleoli
B
FIGURE 4.2B Megakaryoblast, schematic.
Cytoplasm
Nucleus
CYTOPLASM: Basophilic
Granules: Absent by Wright stain
N:C RATIO: 3:1
REFERENCE INTERVAL:
Bone Marrow: 20% of megakaryocyte precursors in bone marrow
Peripheral Blood: 0%
All photomicrographs are ×1000 original magnication with Wright-Giemsa staining unless stated otherwise.
NOTE: The megakaryoblast appears similar to the myeloblast and pronormoblast. Identication by
morphology alone is not advisable.
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SECTION 2 Hematopoiesis
S
T
E
M
P
R
O
G
E
N
I
T
O
R
P
R
E
C
U
R
S
O
R
Multipotent
hematopoietic stem cell
Common myeloid
progenitor
Megakaryocyte-erythrocyte
progenitor
Megakaryoblast
MK-I
Promegakaryocyte
MK-II
Megakaryocyte
MK-III
P
E
R
B
I
L
P
O
H
O
E
D
R
A
L
FIGURE 4.3 Megakaryocyte sequence: promegakaryocyte (MK-II).
Platelets
ChApTER 4 Megakaryocyte Maturation
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PROMEGAKARYOCYTE (MK-II)
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Cytoplasm
A
FIGURE 4.4A Promegakaryocyte (MK-II): bone
marrow (×1000).
SIZE: 15 to 40 μm
NUCLEUS: Indented
Nucleoli: Variable
Chromatin: Condensed
CYTOPLASM: Basophilic
Granules: Present
N:C RATIO: 1:2
REFERENCE INTERVAL:
Bone Marrow: 25% of megakaryocyte precursors in bone marrow
Peripheral Blood: 0%
B
FIGURE 4.4B Promegakaryocyte, schematic.
Nucleus
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SECTION 2 Hematopoiesis
S
T
E
M
P
R
O
G
E
N
I
T
O
R
P
R
E
C
U
R
S
O
R
Multipotent
hematopoietic stem cell
Common myeloid
progenitor
Megakaryocyte-erythrocyte
progenitor
Megakaryoblast
MK-I
Promegakaryocyte
MK-II
Megakaryocyte
MK-III
P
E
R
B
I
L
P
O
H
O
E
D
R
A
L
FIGURE 4.5 Megakaryocyte sequence: megakaryocyte (MK-III).
Platelets
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