BASIC HAEMATOLOGY

MKEB 2403

QUESTIONS

1. Describe briefly the properties of Romanowsky stains

These stains contain eosin Y which an acidic anionic dye, azure B and others
thiazine dye which are the basic cationic dyes. When diluted in buffered
water, ionization occurs. Eosin stains the basic components of blood cells and
the granules of eosinophils stain orange-red. Azure B and other methylene
blue derived dyes, stain the acidic components of cells. Nucleic acids and
nucleoprotein stain various shades of mauve-purple and violet, the granules
of basophiles stain dark blue-violet, and the cytoplasm of monocytes and
lymphocytes stains blue or blue-grey. The staining reactions of Romanowsky
stained are pH dependent which is why the stains are diluted in buffered
water of specific pH.

2. List the Romanowsky stains that are commonly used in routine

haematology
• Wright's stain
• Jenner's stain
• Leishman stain
• Giemsa stain

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3. Explain the terms commonly used in red cell morphology with diagram
a. Microcyte
Smaller than normal red cells, having a diameter of usually less than 6.5
µm

b. Macrocytes
Larger than normal red cells, having a diameter greater than 8 µm

c. Anisocytosis
Unequal variation in the size of red cells

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d. Hypochromasia
Pale staining red cells than normal with increased area of central pallor

e. Anisochromasia

The unequal distribution of haemoglobin in the red blood cells, such

that the periphery is pigmented and the central region is virtually
colourless, as observed in films

f. Polychromasia

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 Blue-Grey or Blue–Mauve staining of immature cells (Reticulocytes)
which are larger in size than normal red cells

g. Poikilocytosis
Various shapes of RBC on the same smear . Unspecific change related
to dyserythropoiesis which look peculiar morphological changes of red
cells

h. Spherocyte
Small densely staining spherical red cells with no central pallor

i. Elliptocyte

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 Egg to cigar shaped of red cells

j. Tear drop cells

Cells shaped like tear drops

k. Ovalocyte
Elongated red cells (synonym: Elliptocytes)

l. Target cells

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 Cells which stain in the centre and periphery with an unstained ring in
between

m. Sickle cells
Elliptical cells with pointed ends, crescent shaped, or boat shaped cells

n. Schistocyte
Irregulary contracted red cell fragments, often with projections
(Spicules)

o. Acantocyte

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 Red cells with multiple irregularly distributed, thorn-like spicules often
with drumstick ends

p. Stomatocyte
Red cells in which the central pallor is straight or appears as a curved
rod-shaped slit

q. “Burr” cells
Crenation is limited (3 to 12 spines or spurs)

r. Crenation
The red cells up to 50 protrusions (spines or spurs) may be observed
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s. Howell-Jolly bodies
Darkly staining small spherical body (nuclear remnant) seen in red
cells. Sometimes more than one to a cell

t. Rouleaux formation
Cells joined together side by side like stacks of coins

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4. Describe the red cell morphology of the film based on the slide prepared
The red cell morphology of the sample tests shown normochromic normocytic
which a normal blood film

5. Draw the different types of white cells. How do you differentiate them

CELL SIZE NUCLEUS CYTOPLASM DIAGRAM

Lobed nucleus
Pale staining
with 3-5 lobes
and containing
separated by
12 – 15 small
Neutrophil chromatin
µm neutrophilic
threads.
mauve staining
Clumped
granules
chromatin
Dark mauve, Thin rim of
Small 10 – 12 compact with blue cytoplasm
lymphocytes µm clumped surrounds the
chromatin nucleus
More
cytoplasm than
small
Round or oval,
Large 12 – 16 lymphocyte,
sometimes
lymphocyte µm pale blue, often
indented
containing
small purple
granules
Monocytes 15 – 20 Round, Clear grey-blue

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 indented, or
cytoplasm,
folded. Stains
containing fine
mauve with
µm granules and
delicate
sometimes
chromatin
vacuoles
pattern
Pale-staining
cytoplasm,
Lobed nucleus,
containing
12 – 17 usually 2 lobes,
Eosinophils orange-red
µm staining dark
granules and
mauve
sometimes
vacuoles
Bilobed (but Contains large
10 – 12 usually darkly staining
Basophils
µm obscured by blue-violet
granules) granules

6. Perform white cell differential count using the specimen given to you.
Record your result
NEUTROPHI LYMPHOCYT EOSINOPHI MONOCYTE BASOPHI
L ES L S L

61 29 5 5 0
TOTAL
100

7. Compare the white cell differential count with the normal ranges. What are
your comments?
By referring the test sample to normal ranges it showed normal blood

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