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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology


Standardization and Grading

Image S1: acanthocytes

Abetalipoproteinaemia - typical
hyperchromic cells with projections of
variable length, thickness and shape

J. Burthem, M. Brereton

Image S2: bite cells

Three bite cells

J. Burthem, M. Brereton

Image S3: blister cells

G6PD deficiency (drug induced


haemolysis) - frequent blister cells with
associated damaged cells

J. Burthem, M. Brereton

Image S4: echinocytes

Renal failure – cells with evenly spaced,


short, blunt projections

J. Burthem, M. Brereton
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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading

Image S5: ovalocytes and


elliptocytes
Hereditary elliptocytosis

J. Burthem, M. Brereton

Image S6: irregularly


contracted cells
Unstable haemoglobin

J. Burthem, M. Brereton

Image S7: schistocytes

Thrombotic thrombocytopenic purpura – a


wide range of fragmented red cells with
polychromatic cells and other damaged
cells. Platelets are absent from the film

J. Burthem, M. Brereton

Image S8: sickle cells

Sickle cell disease – typical forms


together with other features,
notably polychromasia, target
cells, and a spherocytic cell.

J. Burthem, M. Brereton
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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading

Image S9: spherocytes

Autoimmune haemolytic anaemia – typical


round, dense red cells

J. Burthem, M. Brereton

Image S10: stomatocytes


Hereditary stomatocytosis

J. Burthem, M. Brereton

Image S11: target cells

Haemoglobin C disease – target cells in


association with irregularly contracted cells

J. Burthem, M. Brereton

Image S12: tear


drop cells
Myelofibrosis

J. Burthem, M. Brereton
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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading

Image S13: basophilic stippling

Myelofibrosis - two stippled cells, one


in teardrop form

J. Burthem, M. Brereton

Image S14: Howell-Jolly bodies

Auto-splenectomised patient with sickle


cell disease

J. Burthem, M. Brereton

Image S15: Pappenheimer bodies

Sideroblastic anaemia – red cells contain


small basophilic inclusions of variable size
and shape in a limited cytoplasmic area

G. Rozenberg

(**copyright – see statement at end)

Image S16: nucleated red blood cell

Myelofibrosis – a typical late stage


nucleated red cell in circulation

J. Burthem, M. Brereton
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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading

Image S17: large granular


lymphocyte

Large granular lymphocyte from a normal


individual

J. Burthem, M. Brereton

Image S18: Auer rods

AML – two blast cells containing relatively


blunt-ended, single and multiple Auer rods

J. Burthem, M. Brereton

Image S19: hypergranulation


(neutrophils)

Hypergranular neutrophils post G-


CSF treatment

J. Burthem, M. Brereton

Image S20: hypogranulation


(neutrophils)
Myelodysplasia – hypogranular neutrophils.
Note also the atypical nuclear forms

G. Rozenberg

(**copyright – see statement at end)


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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading

Image S21: Pelger


Huet neutrophils

Pelger Huet anomaly – classic bi-lobed


cells with dense chromatin
condensation but normal granulation

J. Burthem, M. Brereton

Image S22: leukaemic


myeloblasts

Acute myeloid leukaemia (AML) –


hypogranular primitive blast cells

J. Burthem, M. Brereton

Image S23: abnormal


promyelocytes in APL (1)
APML – two hypergranular promyelocytes

J. Burthem, M. Brereton

Image S24: abnormal


promyelocytes in APL (2)

Abnormal promyelocyte containing


multiple Auer rods (faggot cell)

G. Rozenberg

(**copyright – see statement at end)


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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading

Image S25: monoblasts

Acute monoblastic leukaemia –


monoblasts and promonocytes

J. Burthem, M. Brereton

Image S26: abnormal


promonocytes

Chronic myelomonocytic
leukaemia (CMML)

G. Zini

Image S27: reactive lymphocytes

Infectious mononucleosis – typical reactive


lymphocytes with flowing basophilic
cytoplasm

J. Burthem, M. Brereton

Image S28: hairy cells


Hairy cell leukaemia

J. Burthem, M. Brereton
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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading

Image S29: follicular


lymphoma cells

Circulating follicular lymphoma cells –


note the small cells with cleaved nuclei
and sparse cytoplasm

J. Burthem, M. Brereton

Image S30: plasma cells

Plasma cell leukaemia. Note also the


background protein staining and the
associated red cell rouleaux. Note that
one plasma cell has features of immaturity
and may be regarded as a plasmablast.

J. Burthem, M. Brereton

Image S31: prolymphocytic


leukaemia cells
B-Prolymphocytic leukaemia

J. Burthem, M. Brereton

Image S32: chronic


lymphocytic leukaemia cells
Typical CLL lymphocytes with a smudge cell

J. Burthem, M. Brereton
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Supplementary images: ICSH Recommendations for Peripheral Blood Cell Morphology
Standardization and Grading

Image S33: giant platelets

Myelofibrosis – some large and giant


abnormally granulated platelets and a
micromegakaryocyte

J. Burthem, M. Brereton

Image S34: hypogranular platelets

Myelofibrosis – variable platelet appearance


with normal and abnormally granulated
platelets together with some large
hypogranular forms

J. Burthem, M. Brereton

Image S35: micromegakaryocytes

Myelofibrosis – note the typical ‘granulated’


platelet cytoplasm. A bare megakaryocyte
nucleus is also present

J. Burthem, M. Brereton

** These images copyright: Microscopic haematology: a practical guide for the laboratory 3e (c)
2011, Sydney, Elsevier Australia