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Cytogram - normal peripheral blood

View larger version (69K): [in this window] [in a new window]   Figure 1. Cytogram of normal peripheral blood obtained with an automated cytochemical analyzer. In, this figure, the peroxidase channel is shown. Total white cell count and differential is generated by plotting cell size (y axis) versus peroxidase content (x axis). The bottom left corner (unlabeled) represents nonspecific noise which includes debris, platelets, red cells, etc. Region A contains the lymphocytes which are small, peroxidase negative cells. Region B marks the area of large, unstained cells (LUC). It extends to the upper left and delineates large peroxidase negative cells. Cells found in this region include atypical lymphocytes, blasts, and even some monocytes. Region C is an intermediate area where monocytes are located, and region D consists of polymorphonuclear cells (PMN – granulocytes). Eosinophils are strongly positive for peroxidase, but because of light absorption, they appear smaller than their actual size, placing them in a region E below the PMN cloud. Basophils (when present) fall within the lymphocyte gate on this plot and require a separate plot (Figure 2) for accurate measurement.

View larger version (38K): [in this window] [in a new window]   Figure 2. Cytogram of the basophil channel: here the size (y axis) is plotted against nuclear density or lobularity (x axis). As one moves right, the x-axis scale measures increasing lobularity. The mononuclear cells (lymphocytes, monocytes, immature granulocytes, and blasts) are found in region A while the polymorphonuclear cells constitute the "tail" in region B. Basophils are identified by their high volume, which places them above the main cloud (region C). In a normal peripheral smear, there are generally only a few events in this region.

View larger version (75K): [in this window] [in a new window]   Figure 3. Lymphocytes are small compared with the other white cells and are peroxidase negative. They can be found in region A of Figure 1.

View larger version (92K): [in this window] [in a new window]   Figure 4. Atypical lymphocytes are larger than normal lymphocytes but are also peroxidase negative. They are generally detected as LUCs (region B of Figure 1).

View larger version (98K): [in this window] [in a new window]   Figure 5. Monocytes are intermediate in size and may have a small number of granules. They are generally found in region C of Figure 1. Some monocytes, however, may have variable morphology and can be found in the LUC region.

View larger version (80K): [in this window] [in a new window]   Figure 6. Neutrophils are granular cells with high peroxidase content. They form a recognizable cluster in region D of Figure 1.

View larger version (105K): [in this window] [in a new window]   Figure 7. Eosinophils are strongly positive for peroxidase. An artifact causes them to appear smaller than their actual size to the hematology analyzer, placing them in region E of Figure 1.

View larger version (97K): [in this window] [in a new window]   Figure 8. Basophils are generally rare in the peripheral blood and are resistant to the cytochemical process, which is used to prepare the other cells for detection. Hence, they retain cell volume and are detected in the regions (C) above the main cloud in Figure 2.

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This Article Figures Only Services Similar articles in this journal Alert me to new content in the Image Bank Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Maslak, P. Search for Related Content PubMed Articles by Maslak, P. Related Collections Absolute values of the differential count in peripheral blood - normal values : adults, children Differential by flow cytometry - meaning of forward and side-scatter Related ASH-SAP Chapter Related Image Bank Image Sets Related ASH Education Book Article Social Bookmarking                   What's this?