Blood

Blood Basics

• Adult has ~ 5.5 L

• Blood consists of cells and plasma
• Blood usually studied in stained smear
– May Grunwald Giemsa
• Blood cells produced in bone marrow from
stem cells
• Hematocrit = volume of packed rbc
– normal male = 40-50%; female = 35-45%
 Plasma

• Plasma - 3500 ml
-90% water
-10% various proteins and organic
substances
albumins 55%
globulins 38%
fibrinogen 7%
 Formed elements

Red Blood White Blood Platelets

Cells Cells

Granulocytes Agranulocytes
Polymorphonucleated Mononucleated

NEUTROPHILS EOSINOPHILS BASOPHILS MONOCYTES LYMPHOCYTES

 Types of Staining in Blood Smears

• Basophilia (deep blue) – afinity for the

basic dye methylene blue
• Azurophilia (bluish red) – afinity for azure
dye; is typical for lysosoms
• Acidophilia (pink) – afinity for acidic dye
eosin; this is a particular feature of
hemoglobin
• Neutrophilia (salmon pink/lilac) –
characteristic of specific granules of
neutrophils
 Erythrocyte

• Biconcave disk
• no nucleus
• ~7.8 µm diameter fresh; 7.2 - 7.4 in
stained smears
• 4-6 million per µL
• Reticulocytes about 1% of total; special
stains: brilliant cresyl blue
Erythrocytes and platelets
Erythrocytes and reticulocytes
Normal RBC Sickled RBC
 Leukocytes (6-10,000 per µL)

• Granulocytes (polymorphonuclear
leukocytes)
– neutrophils 60-70%
– eosinophils 2-4%
– basophils 0.5-1%
• Agranulocytes (mononuclear
leukocytes)
– lymphocytes 20-30%
– monocytes 3-8%
 Neutrophils

• 12-15 µm dia
• multi-lobed nucleus (2-4 lobes)
• in the cytoplasm there are:
• specific (primary and secondary) (0,5 m)
• nonspecific granules;
• Primary granules–azurophilic granules - very small,
round, bluish
• Secondary granules – smaller, salmon pink, alkaline
phosphatase
• Small azurophilic granules: deep red/purple, primary
lysosomes
 Eosinophils

• 12-15 µm diameter,

• bi-lobed nucleus

• are spherical in shape

• Is easy to recognise by its large specific

granules, which stain bright orange /red
 Basophils

• Less than 0.5% of total leukocytes, hard to

find in smears
• 12-15 µm diameter,
• Lobed nucleus, obscured by basophilic
granules
• Many large (~ 1), blue (basophilic)
granules with heparin and histamine
 Lymphocytes

• 6-8 µm dia most common;

• some large lymphs (up to 18 µm dia)
also found in blood
• Round, dark, heterochromatic nucleus
• Thin layer of blue cytoplasm, many
ribosomes
• Differentiation occurs in bone marrow (B
cells) and thymus (T cells)
 Monocytes

• 12-20 µm dia;
• oval or kidney shaped nucleus, eccentric
• Lighter stained nucleus than large
lymphocytes
• Cytoplasm light blue due to azurophilic
granules (lysosomes)
• In tissues, differentiate into macrophages
Monocytes
 Platelets

• Platelets 200,000-400,000 per µL

• Non-nucleated, 2-5 µm dia
• Fragments of megakaryocyte cytoplasm
• Light blue/pink cytoplasm, dark blue/purple
granules
 Platelets

Platelets (arrowheads)
Summary of Formed Elements

Table 17.2
Summary of Formed Elements

Table 17.2