Page 159 - Clinical Hematology Atlas

CHAPTER 14 NUCLEAR AND CYTOPLASMIC CHANGES IN LEUKOCYTES 143

TABLE 14-1 Monocyte versus Reactive Lymphocyte

Monocyte Reactive Lymphocyte
Shape Pleomorphic; may have pseudopodia, which Pleomorphic, easily indented by surrounding
tend to “push away” surrounding cells cells
Size 12-20 mm 10-30 mm
Nucleus Round, oval, horseshoe, or kidney shaped, Irregular, elongated, stretched, occasionally
may have brainlike convolutions round

Nucleoli Absent Occasionally present
Chromatin Loosely woven, lacy Variable; coarse to fine and dispersed
Cytoplasm Blue-gray Pale blue to deeply basophilic, may stain
unevenly

Granules Many fine red—may give ground glass May be a few prominent azurophilic granules
appearance
Vacuoles Absent to numerous Occasional
Use as many criteria as possible to identify cells. It is often difficult to differentiate cells in isolation; multiple fields should be
examined for nuclear and cytoplasmic characteristics. Consider “the company they keep.”

A B
FIGURE 14–8A Monocyte. Note the blue-gray FIGURE 14–8B Reactive lymphocyte. Note the
cytoplasm with fine red granules. Nucleus has blue cytoplasm with darker blue periphery. Cell
brainlike convolutions. Cell “pushes away” is indented by surrounding cells. Nucleus is
surrounding cells. Vacuoles are present in both of elongated. Vacuoles are present in both of these
these figures. figures.