骨髓细胞学检查英文课件（第一部分）

1,Testing of bone marrow cytology (1),2,. The generation, development and normal morphology characteristics of blood cell,3,1. Generation of blood cells,All blood cells come from common hemopoietic stem cell(HBSC). HBSC has two characteristics: 1)the high capability of self-renewal to keep the constancy of the quantity of the stem cell pools; 2)the capability of multi-differentiation. HBSC can differentiate into progenitor cells of every series.,4,Stem cell,Erythropoietin(EPO),Red progenitor cell,Granulocyte-macrophage colony stimulating factor(GM-CSF),Granulocyte-macrophage progenitor cell,Giant nuclear progenitor cell,Meg-CSF and thrombopoietin(TPO),5,Mononuclear cells,Move into various tissues,Histiocytes, or phagocytes,T lymphoid progenitor cells,B lymphoid progenitor cells,B-lymphocytes,Immune cells,Mitogen and antigen,T-lymphocytes,Lymphatic stem cells,Plasma cells,6,2. General principles of morphological evolution during the development of blood cells,7,With the development and maturity of blood cells: (1)Cell volume: from big to small (2)Cytoplasm: 1)volume increased 2)Color turns from deep blue to light blue, even carmoisine 3)Granules in cytoplasm: no granulesazurophil granulesspecific granules(neutral, acidophilic and basophilic strippling),8,(3)nucleus: 1)Size: from big to small From regular to irregular, even with sublobes 2)Chromatin: from fine to rough, tight and dense, color changes from light to deep 3)Nucleole: clearblurreddisappeared 4)Nuclear membrane: unclearclear,9,(4)ratio of cell nucleus and cell-substance From big to small, i.e. from big nucleus with little cytoplasm to small nucleus with abundant cytoplasm(except megakaryocyte),10,11,Evolution of blood cells, 1000x,12,Normal morphologic characteristics of blood cell,1. Erythrocyte series,13,14,(1)normoblast,Sometimes on the edge of cell there are hemisphere or tumor-like ecphymas. Sometimes there is olistherozone surrounding the nucleus with light color.,15,(2)basophilic erythroblast,There are still tumor-like ecphymas and olistherozone surrounding the nucleus.,16,(3) Polychomatic normoblast,17,(4) Ortho-chromatic normoblast,18,(5) Reticulocyte,The reticulocyte is an incompletely mature red blood cell after the orthochromatic normoblast loses its nucleus.,19,(6) erythrocyte,20,2. Granulocyte series,(1)myeloblast Shape: round or elliptical Diameter: 11-18m nucleus constitutes over 2/3 of cell volume Nucleus shape: round or elliptical Chromatin: fine-sand-like, light prunosus, smooth like gossamer Nucleole: 2-5, clear, light blue or colorless Cytoplasm: little, clear sky blue around the nucleus Granules: no or a few,21,(2)promyelocyte Shape: round or elliptical Diameter: 12-22m Nucleus: big, round or oval Chromatin: thick granular or net-like, distributing unevenly Nucleole: clear or disappeared Cytoplasm: comparatively much, light blue or blue Sometimes there is olistherozone near the nucleus Granules: non-specific azurophilic granules, distributed unevenly, with different size, shape and quantity,22,Comparison of 3 kinds of myelocyte,23,Neutrophilic myelocyte,The nucleus constitutes 1/2-2/3 of the cell volume,24,Eosinophilic myelocyte,25,Because of the basophilic granules in the cytoplasm, the nucleus is unclear and the structure of the chromatin is vague.,Basophilic myelocyte,26,(4)metamyelocyte Shape: round or elliptical Diameter: 10-16m Nucleus: kidney-like Chromatin: rough and chunk-like, arranged densely Cytoplasm: abundant, salmon pink, with different specific granules(neutral, acidophilic, basophilic),27,Neutral metamyelocyte,Acidophilic metamyelocyte,Basophilic metamyelocyte,28,(5)stab granulocyte Shape: round Diameter: 10-15m Nucleus: long and narrow, girdle-shaped, both ends are blunt and round Chromatin: rough and chunk-like Cytoplasm: specific granules(neutral, acidophilic, basophilic),29,Neutral stab cell,Acidophilic stab cell,Basophilic stab cell,30,Three types of segmented granulocyte,31,Eosinophilic segmented granulocyte,Basophilic segmented granulocyte,32,3. Lymphocyte series,(1)lymphoblast Shape: round or elliptical Diameter: 10-18m nucleus: big; round or oval Chromatin: exquisite, granular Nucleolus: 1-2, small and clear, light blue or colorless Cytoplasm: clear sky blue Granules: no,33,lymphoblast,There is concentration of chromatin around the inner membrane of nucleus and around the nucleoli, which makes the nuclear membrane thick and clear.,34,(2)prolymphocyte Shape: round or oval Diameter: 10-16m Nucleus: round or elliptical, sometimes with light incision Chromatin: comparatively exquisite and rough Nucleole: vague or disappeared Cytoplasm: little, light blue Granules: without or just with a few big and rare azurophil granules,35,(3) lymphocyte,36,lymphocyte,37,4. Plasmacyte series,38,plasmablast,proplasmacyte,plasmacyte,39,5. Monocyte series,40,41,monocyte,42,6. megakaryocyte system,43,44,Granular megakaryocyte,promegakaryocyte,megakaryoblast,45,(4)Thrombocytogenous megakaryocyte Also called mature megakaryocyte The granules in the cytoplasm are remarkably concentrated, surrounded by platelets. The edge of the cytoplasm splits into platelets. Conglomerate platelets can be seen on the inner and lateral side of cytoplasm.,46,(5)megakaryocyte with naked nucleus After the cyto