Page 181 - Clinical Hematology Atlas

CHAPTER 16 PRECURSOR LYMPHOID NEOPLASMS 165

ACUTE LYMPHOBLASTIC LEUKEMIA, SMALL BLASTS

A B
FIGURE 16–1A Peripheral blood (31000). FIGURE 16–1B Bone marrow (3500).

B
B

A
C

C
C

C D
FIGURE 16–1C Bone marrow demonstrating FIGURE 16–1D Bone marrow demonstrating the
homogeneous blasts in acute lymphoblastic comparison between hemotogones and lympho-
leukemia (31000). blasts. A, Normal lymphocyte; B, hematogones;
and C, lymphoblasts (×1000).
MORPHOLOGY
Peripheral Blood: 6 Blasts, small blasts (about one to NOTE: Hematogones (immature B cells) may be seen
two-and-a-half times the size of a resting lymphocyte) in bone marrow and peripheral blood of newborns,
with scant blue cytoplasm, condensed chromatin or in patients during bone marrow recovery. Care
and indistinct nucleoli, thrombocytopenia must be taken not to confuse hematogones with
Bone Marrow: $20% of all nucleated cells make up small lymphoblasts (see figures 16-1D and 23-4).
a homogeneous population of blasts