Download Blood Disorders Affecting Red Blood Cells Anemia

LAB 12:
BLOOD & BONE
MARROW SMEARS
Prepared by:
Mr:Mahmoud El-Hindi
Miss:Afnan Abdelmoneim
OBJECTIVES
1. Handling and evaluation of blood &
bone marrow smears.
2. Understand methods for detection
INTRODUCTION
• A peripheral blood smear (or blood film):is a thin
layer of blood smeared on a glass microscope slide
and then stained in such a way as to allow the various
blood cells to be examined microscopically.
• Blood films are examined in the investigation of
hematological (blood) disorders and are routinely
employed to look for blood parasites, such as those of
malaria and filariasis.
PREPARATION
• Blood films are made by placing a drop of blood on
one end of a slide.
• Using a spreader slide to disperse the blood over
the slide's length.
• The aim is to get a region; called a monolayer.
• where the cells are spaced far enough apart to be
counted and differentiated.
CONT..
• The slide is left to air dry, after which the blood is
fixed to the slide by immersing it briefly in
methanol.
• The fixative is essential for good staining and
presentation of cellular detail.
• After fixation, the slide is stained to distinguish
the cells from each other.
CONT..
Wright-Giemsa combination stain is also a popular
choice.
These stains allow for the detection of white blood
cell, red blood cell, and platelet abnormalities.
Hematopathologists often use other specialized
stains to aid in the differential diagnosis of blood
disorders.
CONT..
After staining, the monolayer is viewed under a
microscope using magnification up to 1000x.
Individual cells are examined and their morphology
is characterized and recorded.
THERE ARE THREE MAIN CELLS WITHIN
THE BLOOD THAT THE TEST FOCUSES ON:
• red cells (which carry oxygen throughout the
body)
• white cells (which function as part of the body’s
immune system).
• platelets (which are important for blood clotting)
CONT..
Abnormalities in the shape, size, and number of
the red blood cells can affect how oxygen travels
throughout the blood. These abnormalities are
often caused by a mineral or vitamin deficiency,
but can be caused by abnormal proteins such as
in sickle cell anemia.
CONT..
White blood cells are an integral part of the
body’s immune system, a network of tissues and
cells that function to keep the body safe from
invading microorganisms and eliminate existing
infection. Disorders affecting these cells can often
result in the body’s inability to eliminate or control
infections.
CONT..
Platelet disorders affect blood clotting and are often
the result of the body producing the wrong amount
of platelets needed (either too many or too few).
OVERVIEW
Evaluation
of
complete
blood
count
data
and
examination of a peripheral blood smear are the first
diagnostic steps in defining a hematologic disease.
The information gathered from examination of these
data may dictate subsequent diagnostic tests and
procedures.
CONT..
The reliability of the information obtained from the
smear depends to a considerable extent on the
quality of the preparation.
Properly spread films are essential to accurate
work. The slides must be perfectly clean and free of
grease.
DISORDERS
Characteristic red blood cell abnormalities are
anemia, sickle cell anemia and spherocytosis.
Sometimes the microscopic investigation of the red
cells can be essential to the diagnosis of lifethreatening disease (e.g. TTP).
CONT..
White blood cells are classified according to their
propensity to stain with particular substances, the
shape of the nuclei and the granular inclusions.
BLOOD DISORDERS AFFECTING
RED BLOOD CELLS
Anemia : People with anemia have a low number
of red blood cells.
Mild anemia often causes no symptoms.
More severe anemia can cause fatigue, pale skin,
and shortness of breath with exertion
CONT..
Aplastic anemia: In people with aplastic anemia, the
bone marrow does not produce enough blood cells,
including red blood cells.
•
A viral infection, drug side effect, or an autoimmune
condition can cause aplastic anemia.
• Medications, blood transfusions, and even a bone
marrow transplant, may be required to treat aplastic
anemia
CONT..
Sickle cell anemia: A genetic condition that affects
mostly people .
In sickle cell anemia, the red blood cells are sticky
and stiff. They can block blood flow. Severe pain
and organ damage can occur.
CONT..
Polycythemia vera: The body produces too many
blood cells, from an unknown cause.
The excess red blood cells usually create no
problems but may cause blood clots in some
people.
CONT..
Malaria: A mosquito's bite transmits a parasite into a
person's blood, where it infects red blood cells.
• Periodically, the red blood cells rupture, causing
fever, chills, and organ damage.
BONE MARROW ASPIRATE SMEARS
INTRODUCTION
Bone marrow examination refers to the pathologic
analysis of samples of bone marrow obtained by
bone marrow biopsy (often called a trephine biopsy)
and bone marrow aspiration.
Bone marrow examination is used in the diagnosis of
a number of conditions, including leukemia, multiple
myeloma, lymphoma, anemia, and pancytopenia
CONT..
The bone marrow produces the cellular elements of the
blood, including platelets, red blood cells and white blood
cells.
While much information can be gleaned by testing the
blood itself (drawn from a vein by phlebotomy), it is
sometimes necessary to examine the source of the blood
cells in the bone marrow to obtain more information on
hematopoiesis; this is the role of bone marrow aspiration
and biopsy.
NORMAL SMEAR
A WRIGHT'S STAINED BONE MARROW ASPIRATE SMEAR
OF PATIENT WITH PRECURSOR B-CELL ACUTE
LYMPHOBLASTIC LEUKEMIA.
Multiple myeloma
Multiple myeloma is a malignant, clonal disorder of
plasma cells that originates in the bone marrow.
• It’s a relatively common disorder, accounting for 1%
of all malignancies and 10% of all hematologic
malignancies in adults.
• Patients present with painful, lytic lesions of the
bones, recurrent and persistent infections, weakness,
renal failure, and hypercalcemia.
CONT..
Patients
with
myeloma
have
a
monoclonal
proliferation of plasma cells in the bone marrow,
meaning that there are a ton of malignant plasma
cells that all originated from the same initial cell.