Leucocytes Identification

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METHOD OF PREPARING MANUAL
BLOOD SMEARS

Peripheral blood smears are made from
anticoagulate blood or from a fresh drop of blood
from the syringe or a finger-stick puncture.
A drop of blood is placed at one end of a glass
slide. The drop should be sufficiently large to
produce a blood film of at least 2.5 cm.
A second “pusher” slide is held at a 30-45
degree angle to the smear slide. This slide is
drawn back until it touches the drop of blood.
The blood spreads behind the pusher to nearly
the full width of the pusher slide.
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  The pusher slide then is advanced smoothly and quickly to produce a blood smear at least 2. to the end and sides of the smear. Moving the pusher slide forward too slowly accentuates poor leukocyte distribution by pushing larger cells. such as monocytes and granulocytes. 4 .5 cm long that ends approximately 2 cm from the end of the slide.

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  Properly prepared smears (see Fig. The slide edge is an area where small numbers of large-size malignant cells deposit. so this area should be available for scanning.1) should be of a wedge shape. The edges of the smear should not touch the slide edges. with only a slightly rounded end. 6 . Properly prepared smears have a normal gradation from thick to thin. 1.

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mature 10 .Immature.

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500-13.Reference Range : Dewasa 5.000-10.000-18.000-25.500/uL 22 .000/uL Neonatus 10.000/uL 8-12 tahun 4.000/uL 1-7 tahun 6.

Abnormal: >10.000/uL leukositosis ringan 15.000/uL leukositosis berat >50.000-20.000/uL leukositosis sedang 20.000/uL reaksi leukomoid 23 .000/uL leukopenia 10.000-50.000-15.000/uL leukositosis < 5.

5) small granules Band shaped. variable. polymorphic lymphocyte 20-40 7-18µm (1 – 1. basophilic granules S-shaped.3) Large.Blood element % of leukocytes Size (rel. scant Round. Segmented. can be occluded granules eosinophil 1-3 12-17µm (1.8) Eosinophilic staining granules 2-3 lobes neutrophil Band: 2-6 Segment: 50-70 10-15µm (1.5 – 1.2 – 1.1 – 1.9) Basophilic. kidney shaped 24 . acentric amount.25) Basophilic. no granules Large. to RBC) Cytoplasmic staining Nucleus morphology basophil 0 -1 10-14µm (1 – 1. no granules monocyte 2-8 12-20µm (1.

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HITUNG JENIS LEUKOSIT 29 .

penyebaran leukosit memenuhi syaratcounting area Dengan lensa objektif emersi (100 x). leukosit 30 . eritrosit. menilai morfologi trombosit.Prosedur    Seleksi area yg paling baik untuk evaluasi Dengan lensa objektif 10 x perhatikan bagian yang cukup tipis dan rata susunan eritrositnya.

Cara Melakukan Hitung Jenis  Pilih bagian yang cukup tipis dan penyebaran leukosit merata  Mulai menghitung pada pinggir atas sediaan  pinggir bawah  kekanan  pinggir atas lagi  dst  Lakukan terus sampai 100 sel leukosit. dihitung menurut jenisnya  Catat juga kelainan morfologi pada leukosit  Jumlah setiap jenis sel dinyatakan dalam persen  Laporkan jika terdapat eritrosit berinti per 100 leukosit 31 .

sampai terdapat 100 sel  Schilling Hemogram 32 . mengelompokkan tiap 10 sel yang dihitung.hitung jenis dilakukan menggunakan 10 kolom.

Schilling Hemogram Sel 10 10 Basofil 10 10 10 10 10 10 10 10 Jumlah 0 Eosinofil I Batang II Segmen IIII IIII limfosit II III Monosit I II Jumlah 10 10 100 33 .

Monosit : 0-1 % :1–3% :2–6% : 50 – 70 % : 20 – 40 % :2–8% 34 . eosinofil. neutrofil batang.Neutrofil segmen .Neutrofil batang .Basofil .Limfosit .Eosinofil .Melaporkan Hitung Jenis Mulai dengan sel basofil. limfosit dan monosit Nilai normal hitung jenis pada dewasa . neutrofil segmen.

intoksikasi Limfositosis: inf virus Monositosis: malaria 35 .     Basofilia: leukemia granulositik kronik Eosinofilia: asma bronkial. askariasis Neutrofilia: inf bakteri.

References    Young S.. Atlas of Pheriperal Blood.. Anderson’s Atlas of Haematology. 2 nd Ed..F. Hematology : Clinical Principles and Applications.. Lippincott Williams and Wilkins Pereira I.A. Elsevier 36 . et all. Poulsen K. et all. 4 th Ed. Lippincott Williams and Wilkins Rodak B.B.C.

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