Blood Film Staining: Normal and Malignant Cells
Blood Film Staining – Normal & Malignant Cells
Case Study 1
Male 72 yrs
Hb 77g/l (NR 130-180)
RBC 2.23 x 10¹²/l (NR 4.5-6.5)
MCV 88fl (NR 76-96)
WBC 98.2 x 10/l (NR 4-11)
Platelets 28 x 10/l (NR 150-400)
A) Calculation of PCV (packed cell volume or haematocrit) PCV = RBC (cells/l) x 10¯¹² x MCV (fl)
RBC = 2.23 x 10¹²/l
MCV = 88fl or 88 x 10/l
PCV = 2.23 x 88 x10
PCV = 196.24/1000
PCV = 0.196 (NR 0.4-0.54)
B) Calculation of MCH (mean cell volume)
MCH = Hb (g/dl) x 10 RBS (cells/l) x 10¯¹²
Hb = 77g/l or 7.7g/dl
RBC = 2.23 x 10¹²/l
MCH = 7.7 x 10 =34.52 pg (10¯¹²g)/cell (NR 27-32 pg (10¯¹²g)/cell) 2.23
C) Calculation of MCHC (mean corpuscular haemoglobin concentration)
MCHC = Hb (g/dl) PCV (l/l)
Hb = 77g/l or 7.7g/dl
PCV = 0.196
MCHC = 7.7 = 39.3g/dl or 393 g/l (NR 30-35 gt/dl) 0.196
The blood film shows large number of abnormal immature white cells (blasts), possibly hypergranular promyleocytes, which are rare in the blood of healthy person.
Promyleocytes are larger than myeloblasts with more plentiful cytoplasm and consequently a lower nucleocytoplasmic ratio. They cytoplasm is more basophilic than that on myeloblasts and contains azurophilic (pinkish-purple) primary granules. The nucleus is round or oval, is usually eccentric, shows some chromatin condensation and has visible nucleolus. Because they have no specific (lineage-associated) granules, promyleocytes, which are precursors of neutrophils, esinophils or basophils, cannot generally be distinguished from each other (Bain 2004).
Blood count results show low haemoglobin (Hb) concentration in the blood and the red cell count (RBC) is also low, there for packed cell volume (PCV) appears as well low. Mean cell volume (MCV) is within the normal reference range, which means that the red cells are normal size. White blood cell count (WBC) is highly increased and
Case Study 1
Male 72 yrs
Hb 77g/l (NR 130-180)
RBC 2.23 x 10¹²/l (NR 4.5-6.5)
MCV 88fl (NR 76-96)
WBC 98.2 x 10/l (NR 4-11)
Platelets 28 x 10/l (NR 150-400)
A) Calculation of PCV (packed cell volume or haematocrit) PCV = RBC (cells/l) x 10¯¹² x MCV (fl)
RBC = 2.23 x 10¹²/l
MCV = 88fl or 88 x 10/l
PCV = 2.23 x 88 x10
PCV = 196.24/1000
PCV = 0.196 (NR 0.4-0.54)
B) Calculation of MCH (mean cell volume)
MCH = Hb (g/dl) x 10 RBS (cells/l) x 10¯¹²
Hb = 77g/l or 7.7g/dl
RBC = 2.23 x 10¹²/l
MCH = 7.7 x 10 =34.52 pg (10¯¹²g)/cell (NR 27-32 pg (10¯¹²g)/cell) 2.23
C) Calculation of MCHC (mean corpuscular haemoglobin concentration)
MCHC = Hb (g/dl) PCV (l/l)
Hb = 77g/l or 7.7g/dl
PCV = 0.196
MCHC = 7.7 = 39.3g/dl or 393 g/l (NR 30-35 gt/dl) 0.196
The blood film shows large number of abnormal immature white cells (blasts), possibly hypergranular promyleocytes, which are rare in the blood of healthy person.
Promyleocytes are larger than myeloblasts with more plentiful cytoplasm and consequently a lower nucleocytoplasmic ratio. They cytoplasm is more basophilic than that on myeloblasts and contains azurophilic (pinkish-purple) primary granules. The nucleus is round or oval, is usually eccentric, shows some chromatin condensation and has visible nucleolus. Because they have no specific (lineage-associated) granules, promyleocytes, which are precursors of neutrophils, esinophils or basophils, cannot generally be distinguished from each other (Bain 2004).
Blood count results show low haemoglobin (Hb) concentration in the blood and the red cell count (RBC) is also low, there for packed cell volume (PCV) appears as well low. Mean cell volume (MCV) is within the normal reference range, which means that the red cells are normal size. White blood cell count (WBC) is highly increased and
References: Bhagavan, N.V. (2002) Medical Biochemistry, 4th Edition, Harcourt/Academic Press, London, UK Bain, B.J. (2004) A Beginners Guide to Blood Cells, 2nd Edition, Blackwell Publishing, Oxford, UK. Hoffbarand, A.V., Moss, P.A.H & Pettit, J.E. (2006) Essential Haematology, 5th Edition, Blackwell Publishing, Oxford, UK Murphy, K., Travers, P. & Walport, M. (2008) Immunobiology, 7th Edition, Taylor and Francis Group, Abingdon, UK Krafft, A & Breymann, C. (2004) Haemoglobinopathy in Pregnancy: Diagnosis and Treatment,Current Medical Chemistry, 11, 2903-2909