1
Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S1: acanthocytes
Abetalipoproteinaemia - typical hyperchromic cells with projections of variable length, thickness and shape
J. Burthem, M. Brereton
Image S2: bite cells
Three bite cells
J. Burthem, M. Brereton
Image S3: blister cells
G6PD deficiency (drug induced haemolysis) - frequent blister cells with associated damaged cells
J. Burthem, M. Brereton
Image S4: echinocytes
Renal failure – cells with evenly spaced, short, blunt projections
J. Burthem, M. Brereton
2
Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S5: ovalocytes and elliptocytes
Hereditary elliptocytosis
J. Burthem, M. Brereton
Image S6: irregularly contracted cells
Unstable haemoglobin
J. Burthem, M. Brereton
Image S7: schistocytes
Thrombotic thrombocytopenic purpura – a wide range of fragmented red cells with polychromatic cells and other damaged cells. Platelets are absent from the film
J. Burthem, M. Brereton
Image S8: sickle cells
Sickle cell disease – typical forms together with other features, notably polychromasia, target cells, and a spherocytic cell.
J. Burthem, M. Brereton
3
Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S9: spherocytes
Autoimmune haemolytic anaemia – typical round, dense red cells
J. Burthem, M. Brereton
Image S10: stomatocytes
Hereditary stomatocytosis
J. Burthem, M. Brereton
Image S11: target cells
Haemoglobin C disease – target cells in association with irregularly contracted cells
J. Burthem, M. Brereton
Image S12: tear drop cells
Myelofibrosis
J. Burthem, M. Brereton
4
Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S13: basophilic stippling
Myelofibrosis - two stippled cells, one in teardrop form
J. Burthem, M. Brereton
Image S14: Howell-Jolly bodies
Auto-splenectomised patient with sickle cell disease
J. Burthem, M. Brereton
Image S15: Pappenheimer bodies
Sideroblastic anaemia – red cells contain small basophilic inclusions of variable size and shape in a limited cytoplasmic area
G. Rozenberg
(**copyright–see statement at end)
Image S16: nucleated red blood cell
Myelofibrosis – a typical late stage nucleated red cell in circulation
J. Burthem, M. Brereton
5
Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S17: large granular lymphocyte
Large granular lymphocyte from a normal individual
J. Burthem, M. Brereton
Image S18: Auer rods
AML – two blast cells containing relatively blunt-ended, single and multiple Auer rods
J. Burthem, M. Brereton
Image S19: hypergranulation
(neutrophils)
Hypergranular neutrophils post G-CSF treatment
J. Burthem, M. Brereton
Image S20: hypogranulation
(neutrophils)
Myelodysplasia – hypogranular neutrophils.
Note also the atypical nuclear forms
G. Rozenberg
(**copyright–see statement at end)
6
Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S21: Pelger Huet neutrophils
Pelger Huet anomaly – classic bi-lobed cells with dense chromatin condensation but normal granulation
J. Burthem, M. Brereton
Image S22: leukaemic myeloblasts
Acute myeloid leukaemia (AML) – hypogranular primitive blast cells
J. Burthem, M. Brereton
Image S23: abnormal promyelocytes in APL (1)
APML – two hypergranular promyelocytes
J. Burthem, M. Brereton
Image S24: abnormal promyelocytes in APL (2)
Abnormal promyelocyte containing multiple Auer rods (faggot cell)
G. Rozenberg
(**copyright–see statement at end)
7
Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S25: monoblasts
Acute monoblastic leukaemia – monoblasts and promonocytes
J. Burthem, M. Brereton
Image S26: abnormal promonocytes
Chronic myelomonocytic leukaemia (CMML)
G. Zini
Image S27: reactive lymphocytes
Infectious mononucleosis – typical reactive lymphocytes with flowing basophilic cytoplasm
J. Burthem, M. Brereton
Image S28: hairy cells
Hairy cell leukaemia
J. Burthem, M. Brereton
8
Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S29: follicular lymphoma cells
Circulating follicular lymphoma cells – note the small cells with cleaved nuclei and sparse cytoplasm
J. Burthem, M. Brereton
Image S30: plasma cells
Plasma cell leukaemia. Note also the background protein staining and the associated red cell rouleaux. Note that one plasma cell has features of immaturity and may be regarded as a plasmablast.
J. Burthem, M. Brereton
Image S31: prolymphocytic leukaemia cells
B-Prolymphocytic leukaemia
J. Burthem, M. Brereton
Image S32: chronic lymphocytic leukaemia cells
Typical CLL lymphocytes with a smudge cell
J. Burthem, M. Brereton
9
Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S33: giant platelets
Myelofibrosis – some large and giant abnormally granulated platelets and a micromegakaryocyte
J. Burthem, M. Brereton
Image S34: hypogranular platelets
Myelofibrosis – variable platelet appearance with normal and abnormally granulated platelets together with some large hypogranular forms
J. Burthem, M. Brereton
Image S35: micromegakaryocytes
Myelofibrosis – note the typical ‘granulated’ platelet cytoplasm. A bare megakaryocyte nucleus is also present
J. Burthem, M. Brereton
** These images copyright: Microscopic haematology: a practical guide for the laboratory 3e (c) 2011, Sydney, Elsevier Australia