When identifying cells, the first thing to ask yourself is, Does this cell belong in the white or in the red cell series? This sometimes is hard to decide, especially in myelomonocytic leukemia and erythroleukemia. The confusion generally is due to dark-staining cytoplasm in the young white cells. The distinction, however, is easy to make in this photomicrograph, and the characteristic differences to look for are demonstrated. The cell indicated by the arrow on the right is a white blood cell precursor. The nucleoli are light colored and regular in outline. The nucleus stains darker than the cytoplasm. The nuclear chromatin is finer than in the cell on the left, which is a red cell precursor. Granules, if present, are the most helpful finding for differentiating young granulocytes from NRBCs. The cell indicated by the arrow on the left is a basophilic erythroblast, or E2. The cytoplasm is stained darker than the nucleus. The cytoplasm also contains a light spot (Golgi body). This small, light spot near the nucleus is one of the best features for differentiating an searly red cell from a young white cell.
Course Section: 09. Acute Myelomonocytic Leukemia - Monocytic Leukemia - and Erythroleukemia
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