A Beginner's Guide to Blood Cells

Professor Barbara Bain, MB BS, FRACP, FRCPath Professor of Diagnostic Haematology, St Mary's Hospital Campus, Imperial College Faculty of Medicine, Consultant Haematologist, St Mary's Hospital, London, UK

Preface vii

Abbreviations viii

1 The Blood Film and Count 1
Blood 1
The blood film 1
The blood count 17
Normal ranges 20
How to examine a blood film 22

2 Assessing Red Cells 29
Assessing red cell number and distribution (anaemia polycythaemia rouleaux formation red cell agglutination) 29
Assessing red cell size (microcytosis macrocytosis anisocytosis) 32
Assessing red cell shape (poikilocytosis) 32
Assessing red cell colour (hypochromia hyperchromia anisochromasia polychromasia) 32
Detecting red cell inclusions (Pappenheimer bodies basophilic stippling Howell-Jolly bodies) 41
The full blood count in red cell assessment 43

3 Assessing White Cells and Platelets 45
Assessing white cell and platelet numbers 45
Assessing neutrophil morphology 46
Assessing lymphocyte morphology 51
Assessing morphology of monocytes eosinophils and basophils 53
Assessing platelet morphology 53

4 Haematological Findings in Health and Disease 55
The blood film and count in healthy individuals 55
Abnormalities of red cells 56
Abnormalities of white cells 77

5 Emergency Morphology: The Relevance of the Full Blood Count and Blood Film in Acute Illness 97
Thrombocytopenia 97
Thrombotic microangiopathy and microangiopathic haemolytic anaemia 98
Other acute anaemia 100
Kidney injury and disease 105
Acute hepatic damage and liver failure 107
Acute leukaemia 109
Bacterial infection and other causes of leucocytosis 109
Eosinophilia 113
Lymphocytosis 115
Malaria 116
Neutropenia 119
Pancytopenia and leucoerythroblastic blood films 121
Neonatal emergencies 122

6 Selfassessment 125
Index 143