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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S1: acanthocytes
Abetalipoproteinaemia - typical
hyperchromic cells with projections of
variable length, thickness and shape
J. Burthem, M. Brereton
Image S2: bite cells
Three bite cells
J. Burthem, M. Brereton
Image S3: blister cells
G6PD deficiency (drug induced
haemolysis) - frequent blister cells with
associated damaged cells
J. Burthem, M. Brereton
Image S4: echinocytes
Renal failure – cells with evenly spaced,
short, blunt projections
J. Burthem, M. Brereton
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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S5: ovalocytes and
elliptocytes
Hereditary elliptocytosis
J. Burthem, M. Brereton
Image S6: irregularly
contracted cells
Unstable haemoglobin
J. Burthem, M. Brereton
Image S7: schistocytes
Thrombotic thrombocytopenic purpura – a
wide range of fragmented red cells with
polychromatic cells and other damaged
cells. Platelets are absent from the film
J. Burthem, M. Brereton
Image S8: sickle cells
Sickle cell disease – typical forms
together with other features,
notably polychromasia, target
cells, and a spherocytic cell.
J. Burthem, M. Brereton
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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S9: spherocytes
Autoimmune haemolytic anaemia – typical
round, dense red cells
J. Burthem, M. Brereton
Image S10: stomatocytes
Hereditary stomatocytosis
J. Burthem, M. Brereton
Image S11: target cells
Haemoglobin C disease – target cells in
association with irregularly contracted cells
J. Burthem, M. Brereton
Image S12: tear
drop cells
Myelofibrosis
J. Burthem, M. Brereton
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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S13: basophilic stippling
Myelofibrosis - two stippled cells, one
in teardrop form
J. Burthem, M. Brereton
Image S14: Howell-Jolly bodies
Auto-splenectomised patient with sickle
cell disease
J. Burthem, M. Brereton
Image S15: Pappenheimer bodies
Sideroblastic anaemia – red cells contain
small basophilic inclusions of variable size
and shape in a limited cytoplasmic area
G. Rozenberg
(**copyright – see statement at end)
Image S16: nucleated red blood cell
Myelofibrosis – a typical late stage
nucleated red cell in circulation
J. Burthem, M. Brereton
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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S17: large granular
lymphocyte
Large granular lymphocyte from a normal
individual
J. Burthem, M. Brereton
Image S18: Auer rods
AML – two blast cells containing relatively
blunt-ended, single and multiple Auer rods
J. Burthem, M. Brereton
Image S19: hypergranulation
(neutrophils)
Hypergranular neutrophils post GCSF treatment
J. Burthem, M. Brereton
Image S20: hypogranulation
(neutrophils)
Myelodysplasia – hypogranular neutrophils.
Note also the atypical nuclear forms
G. Rozenberg
(**copyright – see statement at end)
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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S21: Pelger
Huet neutrophils
Pelger Huet anomaly – classic bi-lobed
cells with dense chromatin
condensation but normal granulation
J. Burthem, M. Brereton
Image S22: leukaemic
myeloblasts
Acute myeloid leukaemia (AML) –
hypogranular primitive blast cells
J. Burthem, M. Brereton
Image S23: abnormal
promyelocytes in APL (1)
APML – two hypergranular promyelocytes
J. Burthem, M. Brereton
Image S24: abnormal
promyelocytes in APL (2)
Abnormal promyelocyte containing
multiple Auer rods (faggot cell)
G. Rozenberg
(**copyright – see statement at end)
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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S25: monoblasts
Acute monoblastic leukaemia –
monoblasts and promonocytes
J. Burthem, M. Brereton
Image S26: abnormal
promonocytes
Chronic myelomonocytic
leukaemia (CMML)
G. Zini
Image S27: reactive lymphocytes
Infectious mononucleosis – typical reactive
lymphocytes with flowing basophilic
cytoplasm
J. Burthem, M. Brereton
Image S28: hairy cells
Hairy cell leukaemia
J. Burthem, M. Brereton
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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S29: follicular
lymphoma cells
Circulating follicular lymphoma cells –
note the small cells with cleaved
nuclei and sparse cytoplasm
J. Burthem, M. Brereton
Image S30: plasma cells
Plasma cell leukaemia. Note also the
background protein staining and the
associated red cell rouleaux. Note that
one plasma cell has features of immaturity
and may be regarded as a plasmablast.
J. Burthem, M. Brereton
Image S31: prolymphocytic
leukaemia cells
B-Prolymphocytic leukaemia
J. Burthem, M. Brereton
Image S32: chronic
lymphocytic leukaemia cells
Typical CLL lymphocytes with a smudge cell
J. Burthem, M. Brereton
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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading
Image S33: giant platelets
Myelofibrosis – some large and giant
abnormally granulated platelets and
a micromegakaryocyte
J. Burthem, M. Brereton
Image S34: hypogranular platelets
Myelofibrosis – variable platelet appearance
with normal and abnormally granulated
platelets together with some large
hypogranular forms
J. Burthem, M. Brereton
Image S35: micromegakaryocytes
Myelofibrosis – note the typical ‘granulated’
platelet cytoplasm. A bare megakaryocyte
nucleus is also present
J. Burthem, M. Brereton
** These images copyright: Microscopic haematology: a practical guide for the laboratory 3e (c)
2011, Sydney, Elsevier Australia