MORPHOLOGY OF WBC AND

PLATELETS ON PERIPHERAL SMEAR

PRESENTER- DR.SUMAYIA
Normal WBC Count = 4,000 – 10,000/cu mm or
4 – 10 x 109 /L
• Differential Count:
• Neutrophil = 40 – 80 %
• Eosinophil = 1 – 6 %
• Basophil = <1-2 %
• Lymphocytes = 20 – 40 %
• Monocytes = 2 – 10 %
Wbc can divided into granulocytes and agranulocytes

Granulocytes:

1.Neutrophils
2.Eosinophils
3.Basophile

Agranulocytes:

1.Lymphocytes
2.Monocytes
Neutrophils / PMN- Polymorphonuclear leucocytes

Appearance:

pink granules in cytoplasm, nucleus has 3- 4 lobes

Diameter: 12-15micrometer
• Function: Phagocytosis of bacteria
• Azurophilic (1°) granules are "lysosomes of PMNs", occur in all
leukocytes.
NEUTROPHIL
Neutrophila (ANC >7,500/cmm)

•Infections (especially pyogenic )

•Inflammation, Metabolic disorders

• Acute hemorrhage, corticosteroids

• Stress, post-surgery, burns, HDN

• Lithium drugs, neoplasms,smoking.

Neutropenia (ANC<2000/cmm)

• Decreased production of neutrophils-Inherited/acquired stem

cell disorder
-Benzene toxicity, cytotoxic drugs

• Increased destruction - Immune mechanism, sequestration

• BM depression, IM, varicella, Typhoid
• SLE, hepatitis or any viral infections
Eosinophil

• Bilobed nucleus
• Diameter : 10-20micrometer
• 1-6% of WBC
• Recruited to sites of inflammation

• Function: Involved in allergy, parasitic infections.

• Contains: Eosinophilic granules
• Granules contain: Major basic protein Azurophilic
granules
Eosinophil
Eosinophilia (AEC> 600/cmm)

Allergic disorders (asthma)

• Parasitic infections (nematodes)
• Skin disease (eczema)
• Hodgkin’s disease
• Scarlet Fever
• Pernicious anemia
Eosinopenia (AEC<50/cmm)

• Stress due to trauma or shock

• Mental distress

• Cushing’s syndrome

• ACTH administration
Basophil

Circulating form of mast cells

• <1-2% WBC
• Diameter- 12-15micrometer
• Contains: basophilic granules
• Granules contain: histamine and heparin
• IgE receptors
• Involved in allergy
Basophilia (ABC>100/cmm)

chronic myeloid leukemia

Polycythemia Vera

Hodgkin's disease

Basopenia

Hyperthyroidism
Pregnancy
Lymphocyte

• small and large lymphocytes (diameter -12-

15micrometer)

• Small (same size as rbc)

• little visible cytoplasm

•NO specific granules

• 20-40% of WBC

•T cells: CMI (for viral infections)

• B cells: humoral (antibody)

• Natural Killer Cells

LYMPHOCYTOSIS (ALC>4000/CMM

• Viral infections ( German measles )

• Infectious Mononucleosis (kissing dis.)

• Mumps (parotitis), pertussis

• Tuberculosis, syphilis, thyrotoxicosis

LYMPHOCYTOPENIA (ALC<1500/CMM)

• Congestive heart failure, SLE

• Renal failure

• Advanced Tuberculosis

• High levels of adrenal corticosteroids

Monocyte / macrophage

• 2-10% of WBC, diameter 12-20microns

• Circulating form (precursor) of tissue macrophages

• Recruited to sites of inflammation Macrophages

• Phagocytosis, bacterial killing, antigen presentation

• Peritoneal cavity: peritoneal macrophages

• Lung: alveolar macrophages

• Spleen: splenic macrophages

MONOCYTE
Monocytosis (AMC>1000/CMM)

• Syphilis, Tuberculosis

• Protozoan infections

• Mycotic or fungal infections

• Malaria, Systemic lupus erythematosus

• Rheumatoid arthritis
MONOCYTOPENIA

• LYMPHOCYTIC LEUKAEMIA

• APLASTIC ANAEMIA
Platelets

• Platelets are released from the megakaryocytes, likely

under the influence of flow in the capillary sinuses.

• Main regulator of platelet production is the hormone

thrombopoietin (TPO), which is synthesized in the liver.

• Normal BLOOD platelet count = 150,000–450,000/L.

• platelet synthesis increases with inflammation and

specifically by interleukin 6.
• Platelets are anucleate and they have limited capacity to
synthesize new proteins

• Diameter 3-4microns

• Circulate with an average life span of 7–10 days.

• Approximately 1/3 of the platelets reside in the spleen, and

this number increases in proportion to splenic size,
although the platelet count rarely decreases to <40,000/L as
the spleen enlarges.
Thrombocytosis (platelets>4.5l)

•Blood loss.

•Cancer.

•Infections.

•Iron deficiency.

•Removal of your spleen.

•Hemolytic anemia
Thrombocytopenia (platelets<1.0l)

•Leukemia and other cancers.

•Some types of anemia.

•Viral infections, such as hepatitis C or HIV.

•Chemotherapy drugs and radiation therapy.

•Heavy alcohol consumption.

Thank you