LAB ACTIVITY

MORPHOLOGY OF ERYTHROCYTE,
LEUCOCYTE AND THROMBOCYTE
NORMAL
Sara Puspita,dr.,SpPK
Clinical Pathology Departement – FK UNISBA

HEMATOPOIETIC DEVELOPMENT

• Hematopoiesis is the continuous, regulated process of renewal, proliferation,

differentiation, and maturation of all blood cell lines.
• These processes result in the formation, development, and specialization of
all functional blood cells that are released from the bone marrow into the
circulation.
• During fetal development, the restricted, sequential distribution of cells is
initiated in the yolk sac and then progresses in the aorta-gonad-mesonephros
(AGM) region (mesoblastic phase), then to the fetal liver (hepatic phase),
and finally resides in the bone marrow (medullary phase).
• Healthy adults , hematopoiesis is restricted primarily to the bone marrow.
 E RY T H R O P O I E S I S

• Erythropoiesis occurs in the bone marrow and is a complex,

regulated process for maintaining adequate numbers of
erythrocytes in the peripheral blood.
• approximately 10^12 new erythrocytes (red cells) each day
• One pronormoblast usually gives rise to 16 mature red cells
• Nucleated red cells (normoblasts) are not present in normal human
peripheral blood
• The most important features in the identification of RBCs are the
nuclear chromatin pattern (texture, density, homogeneity), nuclear
diameter, nucleus-to-cytoplasm (N:C) ratio, presence or absence of
nucleoli, and cytoplasmic color.
 ERITHROPOIESIS

Reticulocyte Mature
RBC

C
NuclearDNA Yes

KIASincytoplasm Yes Yes No

inmarrow Yos

inbiood

Figure2.3ComparisonoftheDNAandRNAcontent.
andmarrowandpenoneraloooisnoutonofthe

erythroblast(normoblast),reticulocyteandmaturered
ERITHROPOIESIS
bloodcell(RBC)

1. Overall diameter of the cell

decreases.
2. Diameter of the nucleus
decreases more rapidly than does
the diameter of the cell. As a result,
the N:C ratio also decreases.
3. Nuclear chromatin pattern
becomes coarser, clumped, and
condensed, and the nucleus is
said to be pyknotic.
4. Nucleoli extruded & disappear.
5. Cytoplasm changes from blue to
gray-blue to salmon pink.
PRONORMOBLAST/RUBRIBLAST/PROERYTHROBLAST
pseudopodi
Perinuclear
halo

nucleol
i

- Round
- Primitive nucleus, visible nucleoli
- N:C ratio 8:1 to 6:1
- 14 – 24 um, 1-2 nucleoli
- Usually slight larger than myeloblast and
has more cytoplasm-> deeper blue (>>
ribosome and RNA)
- Perinuclear halo
- Sometimes pseudopodi

BASOPHILIC NORMOBLAST
(PRORUBRICYTE/BASOPHILIC
ERYTHROBLAST)
- Smaller than pronormoblast
- N:C 6:1 to 4:1, 12-17 um
-Coarsening of the chromatin
pattern than pronormoblast
- The nucleoli ill defined or not
visible
- More RNA and hemoglobin
- the cytoplasm may be a
deeper,richer blue than in the
pronormoblast due to RNA but
can be pinkish tinge reflecting
hb
POLYCHROMATOPHILIC NORMOBLAST/
RUBRICYTE/ POLYCHROMATOPHILIIC
ERYTHROBLAST

- smaller, 10-15 um
- Hb twice than basophilic norm.
- More cytoplasma than basophilic
norm.
- Cytoplasm Pink blue due to Hb and
RNA, late stage more pink
- Nuclear chromatin is thickened and
irregularly condensed (irregular
pyknotic mass)
- 4:1 to 2:1

ORTHOCROMATIC
NORMOBLAST/METARUBRYCITE/
ORTHOCROMATIC ERYTHROBLAST
- solid, blue back, degenerated
nucleus with a non linear
clumped chromatin pattern
- Nucleus pycnotic (no white
areas)
- Cytoplasm predominantly pink
or redish but remain minimal
blue cytoplasm due to RNA
- N;C 1:1 to 1:2
 RETICULOCYTE (DIFFUSELY BASOPHILIC
ERYTHROCYTE, POLYCHROMATOPHILIC ERYTHROCYTE)
Reticulocytes: reticular material (precipitated RNA
and protein) is shown clearly in normal blood by
supravital staining with new methylene blue
- Larger than mature red cell 8-10um
- Released 2-3 day from BM and circulates 1-2 day
before mature
The cytoplasm can be compared with that of the
late orthochromic normoblast in that the
predominant color is that of hemoglobin yet with a
bluish tinge due to some residual ribosomes and
RNA.

ERITHROCYTE (RED BLOOD CELL, DISCOCYTE)

• Nucleus. No nucleus is present in mature RBCs.
• Cytoplasm. The mature circulating erythrocyte is a
biconcave disc measuring 7 to 8 um in diameter,
with a thickness of about 1.5 to 2.5 um. On a
Wright-stained blood film, it appears as a salmon-
pink stained cell with a central pale area that
corresponds to the concavity. The central pallor is
about one-third the diameter of the cell.
• Division. The erythrocyte cannot divide.
• Not able to synthesize HB
Erythrocyte
Size + diameter of small lymphocyte
Shape round
Color red, with central pallor which is < ½
diameter
 ERITHROPOIESIS

LEUKOPOIESIS
 LEUKOPOIESIS
Terminology base on cytoplasm

CYTOPLASMIC GRANULES (IN MYELOID

CELLS)

•Azurophil = primary granules

•Specific = secondary granules

Eosinophilic
Basophilic
Neutrophilic
 NUCLEAR MATURATION

SHAPE
Round or oval in blasts
Striking changes in granulocytes

STRUCTURE
Delicate netlike or spongelike chromatin in
blasts
Chromatin strands become more coarse and
clumped as the cells matures
Reduction in the number of nucleoli

GRANULOPOIESIS

MYELOCYTE
METAMYELOCYTE
BAND CELL
SEGMENTED CELL
 GRANULOPOIESIS
MYELOBLAST

PROMYELOCYTE

MYELOCYTE

METAMYELOCYTE

BAND CELL

SEGMENTED CELL

MYELOBLAST
SIZE: Ø 10 – 20 µm,
N/C ratio 6:1
NUCLEUS: occupies most of the cell, round or oval, thin
membrane, fine dotted or network pattern
chromatin.Nucleoli 2 – 5 usually distinct because surrounded
by chromatin
CYTOPLASM: deep blue, scanty, could be as a rim around
the nucleus, no granules
PROMYELOCYTE
SIZE: Ø 14 – 20 µm,
N/C ratio 5:1
NUCLEUS: round, thin membrane, a network of coarse
chromatin
CYTOPLASM: not homogenous, light blue with wine red &
irregular azurophilic granules

MYELOCYTE
SIZE: Ø 10 – 18 µm,
N/C ratio 5:1
NUCLEUS: round, eccentris, usually no nucleolus, but could be
single, coarse chromatin
CYTOPLASM: contains the largest quantity of azurophilic granules.
Specific granules are formed could be eosinophilic, basophilic or
neutrophilic
 METAMYELOCYTE
SIZE: Ø 10 – 18 µm,
N/C ratio: 1.5 : 1
NUCLEUS: renal shape, thick membrane, coarse chromatin no
nucleolus
CYTOPLASM: pink with specific granules

BAND CELL
SIZE: Ø 10 – 15 µm,
N/C ratio 1.5:1
NUCLEUS: band shape, coarse
chromatin
CYTOPLASM: pink with specific
granules

SEGMENTED CELL
SIZE: Ø 10 – 15 µm,
N/C ratio 1:3
NUCLEUS: segmented, connected with thin filaments, usually 2 – 3
lobuli, coarse block like chromatin
CYTOPLASM: pink, abundant with specific granules
 MONOPOIESIS
MONOBLAST
PROMONOCYTE
MONOCYTE

Monocyte development is similar to neutrophil development

because both cell types are derived from the GMP
 MONOBLAST
SIZE Ø 14 – 18 m ,
N/C ratio 6:1
NUCLEUS: round or oval, sometimes with indentation, Thin nuclear
membrane ,fine chromatin , Nucleoli 1-2
CYTOPLASM: blue, it is darker than the myeloblast but lighter than
lymphoblast
•Monoblasts in normal bone marrow are very rare and are difficult to
distinguish from myeloblasts based on morphology

PROMONOCYTE
SIZE: Ø 14 – 18 m,
N/C ratio 5:1
NUCLEUS : with indentation, thin membrane
Chromatin in coarse clumps, Nucleolus 0 – 1
CYTOPLASM: pale blue
This cell can not be found in the peripheral blood, except in tbc,
RES disorders, and monocytic leukemia

MONOCYTE
SIZE: Ø 12 – 18 µm,
N/C ratio 4:1
NUCLEUS: indented or coiled, Sometimes with 2 – 3 lobuli or like the letter E,
Scarce chromatin and loose structure
CYTOPLASM : blue with fine azurophilic granules,
Vacuoles can be found near the nuclear indentation Bacteria, parasites can be
found due to phagocytosis
•Under conditions of increased demand for monocytes, promonocytes undergo four
divisions to yield a total of 16 monocytes in 60 hours.
Macam2 bentuk monosit
dlm darah tepi
 LYMPHOPOIESIS

LYMPHOBLAST

PROLYMPHOCYTE

LYMPHOCYTE

LYMPHOBLAST
SIZE: Ø 10 – 18 µm,
N/C ratio 5:1
NUCLEUS: round or oval, distinct membrane,
fine to coarse chromatin, nucleoli 1-2
CYTOPLASM: homogenous, blue, often a perinuclear zone
with lighter blue color, no granules

PROLYMPHOCYTE
SIZE: Ø 10 – 18 µm,
N/C ratio 5:1
NUCLEUS: round or oval, can be indented,
coarser chromatin than lymphoblast, nucleolus
0–1
CYTOPLASM: homogenous, can contain
azurophilic granules
Sometimes difficult to identify with a
lymphoblast
SMALL LYMPHOCYTE
SIZE: Ø 6 – 18 µm,
N/C ratio 3-2 : 1
NUCLEUS: round or oval with deep or shallow
indentation, coarse clumped chromatin, no nucleolus
CYTOPLASM: scanty, could only be a rim around the
nucleus, light blue

LARGE LYMPHOCYTE
SIZE: Ø 20 µm
NUCLEUS: not dense chromatin

CYTOPLASM: pale blue and wide

PLASMACYTE
SIZE: Ø 10 – 20 µm,
NUCLEUS: round or oval, eccentris, coarse and clumped
chromatin

CYTOPLASM: blue with perinuclear zone, not homogenous

with small vacuoles
This cell can be found in the peripheral blood of patients with infectious mononucleosis,
rubella, hepatitis infectiosa, multiple myeloma and typhus abdominalis
 THROMBOPOIESI
S
MEGAKARYOBLAST
PROMEGAKARYOCYTE
MEGAKARYOCYTE
THROMBOCYTE

MEGAKARYOBLAST
SIZE: Ø 25 –35 µm,
N/C ratio 10:1
NUCLEUS: oval or indented, dense & fine
chromatin, Nucleoli 2 – 6

CYTOPLASM: scanty, pale blue

PROMEGAKARYOCYTE

SIZE: Ø 25 – 50 µm,

N/C ratio 6:1

NUCLEUS: irregular with many
lobuli, nucleoli 0 – 2
CYTOPLASM: moderate blue with
fine azurophilic granules near the
nucleus.
MEGAKARYOCYTE
SIZE: Ø 40 – 100 µm,
N/C ratio 1-2 : 1
NUCLEUS: multilobuli and irregular, clumped irregular
chromatin, no nucleolus
CYTOPLASM: light blue with pink granules
This cell is the largest blood cell

THROMBOCYTE
SIZE: Ø 2 – 4 µm,
The smallest blood cell, a
fragment of the cytoplasm of a
megakaryocyte
Morphology of blood cells should be examined
in the area where the erythrocytes are separated
from each other and with a central pallor
TERIMA KASIH
 REFERENSI

1. Keohane EM, Otto CN, Walenga JM. Rodak's Hematology Clinical

Principles and Applications: Elsevier; 2020.

2. Harmening DM. Clinical Hematology and Fundamental of Hemostasis.

Edisi ke-5. Philadelphia: F.A Davish Company;2009.

• Hoffbrand and Moss. 2016. Chap 1. Haematopoiesis, in Hoffbrand’s Essential

Haematology, 7ed