LEARNING GUIDE: HEMATOLOGY DIAGNOSTICS

Section 5

WHITE BLOOD
CELLS
LEARNING OBJECTIVES
When you complete this section, you will be able to:
1. Recognize descriptions of the various WBCs
2. Indicate their primary functions

LEARNING GUIDE: HEMATOLOGY

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 ORIGIN AND DEVELOPMENT OF HUMAN BLOOD CELLS
PLURIPOTENTIAL
HEMATOPOIETIC
STEM CELL

MYELOBLAST MONOBLAST MEGAKARYOBLAST PRONORMOBLAST B LYMPHOBLAST T LYMPHOBLAST

LEARNING GUIDE: HEMATOLOGY

PROMYELOCYTE BASOPHILIC NORMOBLAST

PROMONOCYTE PROMEGAKARYOCYTE

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Figure 4. The developmental progression of WBCs, RBCs and platelets.
BASOPHILIC MYELOCYTE MYELOCYTE EOSINOPHILIC MYELOCYTE POLYCHROMATIC
PROPLASMACYTE PROLYMPHOCYTE
NORMOBLAST

MEGAKARYOCYTE
WITHOUT PROPLATELETS

BASOPHILIC EOSINOPHILIC ORTHOCHROMIC

METAMYELOCYTE
METAMYELOCYTE METAMYELOCYTE NORMOBLAST

POLYCHROMATIC
BASOPHILIC BAND BAND EOSINOPHILIC BAND
MEGAKARYOCYTE ERYTHROCYTE
WITH PROPLATELETS

BASOPHIL SEGMENTED NEUTROPHIL EOSINOPHIL MONOCYTE PLATELETS ERYTHROCYTE B LYMPHOCYTE T LYMPHOCYTE

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DIAGNOSTICS
LEARNING GUIDE: HEMATOLOGY DIAGNOSTICS

GRANULOCYTES
ORIGIN AND DEVELOPMEN
Granulopoiesis is the formation of granulocytes, the most numerous white cell. As a granulocyte matures,
the cell nucleus undergoes many changes; it shrinks, indents, assumes a band form, and segments. Granules PLU
containing enzymes and antibacterial agents appear; they are clearly evident in Figure 5. Myelocytes are HEM

distinguished according to the staining characteristics of their granules: neutrophilic, eosinophilic, and
basophilic. Mature granulocytes are polymorphonuclear cells (PMNs) (sometimes called polys).

MYELOBLAST MONOBLAST MEGAKARYO

PROMYELOCYTE

PROMONOCYTE PROMEGAKAR

BASOPHILIC MYELOCYTE MYELOCYTE EOSINOPHILIC MYELOCYTE

MEGAKARY
WITHOUT PRO

BASOPHILIC EOSINOPHILIC
METAMYELOCYTE
METAMYELOCYTE METAMYELOCYTE

BASOPHILIC BAND BAND EOSINOPHILIC BAND

MEGAKARYO
WITH PROPLA

BASOPHIL SEGMENTED NEUTROPHIL EOSINOPHIL MONOCYTE PLATEL

Figure 5. Granulocytes. Granules are evident in each cell. C-F are basophils, G-J are neutrophils, and
K-N are eosinophils. E, I, and M are band forms. F, J, and N are segmented forms.
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 LEARNING GUIDE: HEMATOLOGY Plate 7. Monocytes
DIAGNOSTICS

Normally, granulocytes are regulated at a constant level. During infection, the number of granulocytes rises
dramatically.
Functions of Granulocytes. Neutrophils seek out and kill bacteria – a process called phagocytosis (see
below). Eosinophils attack some parasites and inactivate mediators released during allergic reactions.
Basophils contain histamine and are important in immunity and hypersensitivity reactions; they also
contain heparin (an anti-clotting substance), but their role in blood clotting is uncertain.
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QUICK REVIEW: PHAGOCYTOSIS
MEANING LITERALLY, CELL EATING
7A. Monocyte with “ground-glass” 7B. Monocyte with blue granular 7C. M
Cells Plate 7. Monocytes appearance, evenly distributed fine
Phagocytes – neutrophils (PMNs, polys), macrophages cytoplasm, lobulation of nucleus gran
granules, occasional azurophilic with linear chromatin nucle
granules, and vacuoles in cytoplasm
Process Foreign substances (antigens) invade
Plasma factors (including lymphocytes and basophils) attract phagocytes to
Chemotaxis
the invaded area
Plasma factors (immunoglobulins) coat antigens to make them “tasty” for
Opsonization
phagocytes

Phagocytes bind to and ingest antigens. (Neutrophils can ingest 5-25 bacteria before dying; macrophages
live longer because they can extrude toxic substances.)

MONOCYTES/MACROPHAGES
7A. Monocyte with “ground-glass” 7B. Monocyte with blue granular 7C. Monocyte with prominent
After
appearance, a distributed
evenly short time fine in thecytoplasm,
blood, lobulation
monocytes enter
(Figure 6)granules
of nucleus andtissue, grow larger, and become
deeply indented
7D. Monocyte without nuclear
tissue
7E. Monocyte with gray-blue 7F. M
granules, occasional azurophilic with linear chromatin nucleus
macrophages. Once it was incorrectly thought that endothelial
granules, and vacuoles in cytoplasm indentations cells (cells lining blood vessels)
cytoplasm, performed
band type of nucleus, cytop
the same function as macrophages. This is the origin of the name reticuloendotheliallinear system (RES);
chromatin, blunt pseudo- mult
pods, and fine granules
macrophage system is more accurate.

7D. Monocyte without nuclear 7E. Monocyte with gray-blue 7F. 7G. Monocyte
Monocyte withwith segmented-type
gray-blue 7H. Monocyte with multiple blunt 7I. M
indentations cytoplasm, band type of nucleus, nucleus blunt pseudopods, and
cytoplasm, nongranular pseudopods, nuclear nong
linear chromatin, blunt pseudo- multilobulated nucleus indentations, and folds granu
pods, and fine granules

Figure 6. Monocytes. E = band form. G = segmented form.

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7G. Monocyte with segmented-type 7H. Monocyte with multiple blunt 7I. Monocyte with vacuoles,
LEARNING GUIDE: HEMATOLOGY Plate 5. Lymphocytes DIAGNOSTICS

5A. Small lymphocyte 5B. Lymphocyte of 5C. Lymphocyte with

intermediate size indented nucleus

5D. Lymphocyte of 5E. Lymphocyte with pointed 5F. Spindle-shaped

intermediate size cytoplasmic projections (frayed lymphocyte with
cytoplasm) indented nucleus

5G. Large lymphocyte with indented 5H. Large lymphocyte 5I. Large lymphocyte with
nucleus and pointed cytoplasmic purplish-red (azurophilic)
projections granules

5J. Large lymphocyte with irregular 5K. Large lymphocyte with purplish-red 5L. Large lymphocyte with
cytoplasmic contours (azurophilic) granules and with purplish-red (azurophilic)
indentations caused by pressure of granules
erythrocytes

Figure 7. Large and small lymphocytes.

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LEARNING GUIDE: HEMATOLOGY DIAGNOSTICS

Activated by the immune system, macrophages are the body’s first line of defense. Powerful and long-lived,
macrophages can ingest large particles – whole RBCs, parasites, bacteria – and rid the body of dead or
damaged cells and other debris. Macrophages fixed in tissue often look different and have different names,
e.g., Kupffer cells in the liver are macrophages.
Macrophages and Neutrophils. Areas of inflammation attract both macrophages and neutrophils. The
few tissue macrophages present begin to attack invaders. Within a few hours, the second line of defense
appears: the number of neutrophils in the blood increases substantially as substances in the blood stimulate
bone marrow to release stored neutrophils. The third line and the long-term chronic defense is the
proliferation of macrophages by cell reproduction in the tissue, by attracting monocytes from the blood, and
by increased production of monocytes.

QUICK REVIEW: CELLS OF THE RES OR TISSUE MACROPHAGE SYSTEM

DESCRIPTIONS
Fixed macrophages: (reticulum cells) large
cells, small nucleus
Free macrophages: large wandering cells
Circulating monocytes: large, motile cells with
indented nuclei
Table 5. Cells of the RES or tissue macrophage system.
LOCATIONS
Spleen, lymph nodes, bone marrow, liver, skin
(histiocytes), lungs (macrophages), etc.
Spleen, lymph nodes, lungs,many other tissues
Blood

LYMPHOCYTES PLAY A KEY ROLE IN IMMUNITY (Figure 7)

T lymphocytes (T cells). Involved in cellular immunity, T cells carry receptors for molecules on other cells
or in body fluids. T cell receptors allow them to interact with macrophages and other cells and substances
in the body. T cells defend against foreign substances such as viruses that invade body cells, fungi, parasites,
transplanted tissue, and cancer cells. Through a variety of T cells (helper T cells, suppressor T cells), the
body initiates, carries through, and terminates antigen-antibody reactions to provide immunity.
B lymphocytes (B cells) are involved in humoral immunity, which consists of antibodies circulating in the
blood and lymphatic system. B lymphocytes produce antibodies typically against bacteria and viruses.
Example: AIDS. In AIDS (acquired immune deficiency syndrome), the virus (HIV) infects the helper T
lymphocyte cells and destroys them. It can also pass unrecognized from cell to cell by changing the surface
of helper T cells. HIV may lie dormant until another infection triggers T cells to increase and the virus to
multiply. With HIV, not only is part of the body’s defense system lost, but the very cells that should defend
the body are working against it.

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