Blood Cell Atlas

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P/N:ENG-Blood Cell Atlas-140210X56P-20220520
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Introduction
The cell images in this blood cell atlas were photographed by an MC-80
Automated Digital Cell Morphology Analyzer on peripheral blood smears
prepared by an SC-120 Slide Maker & Stainer following a standard
Romanovsky staining procedure.

01
Content

Normal Peripheral Blood Cells

Band Neutrophil Granulocytes 04
Segmented Neutrophil Granulocytes 06
Lymphocytes 08
Monocytes 10
Eosinophils 12
Basophils
Red Blood Cells and Platelets
14
16
Normal
Peripheral Blood Cells
Abnormal Peripheral Blood Cells
Neutrophil Phagocytosis of Fungi or Parasites 19
Toxic Changes in Neutrophils 20
Blast cells 22
Promyelocytes 24
Abnormal Promyelocytes 26
Neutrophilic Myelocytes 28
Neutrophilic Metamyelocytes 30
Reactive Lymphocytes 32
Abnormal Lymphocytes 34
Plasma Cells 38
Abnormal Platelets 40
Megakaryocytes 42
Nucleated Red Blood Cells 44
Smudge Cells 46
Artefacts 47

02
Band Neutrophil Granulocytes Atlas of typical blood cells

The cells are 10–15 μm in diameter, round-shaped with typically rod-shaped, Band neutrophil granulocytes increased or/and the presence of
band-like, or sausage-like nuclei, having coarse, agglutinated nuclear metamyelocytes, myelocytes, or even promyelocytes in peripheral blood are
chromatin in deep violet-pink color. The cytoplasm is abundant and pink, referred to as a "left shift" and commonly seen in infections (especially acute
with a large number of small violet-pink granules. septic infections), acute poisoning, acute blood loss, and aplastic anemia.

04 05
Segmented Neutrophil Granulocytes Atlas of typical blood cells

The cells are 10–15 μm in diameter with a lobulated nucleus divided into 2–5 Increased neutrophil count with >3% neutrophils containing 5 or more
lobes (with 3-lobe nuclei accounting for 40–50%), having deep violet coarse nuclear lobes in peripheral blood is referred to as a "right shift", commonly
nuclear chromatin with abundant cytoplasm that contains a large number of observed in patients with nutritional megaloblastic anemia, under
light pink, small, and uniform neutral granules. anti-metabolic drug treatments, or during recovery from inflammations. A
severe right shift of nuclei is often accompanied by a decreased total white
blood cell count, suggesting a decline in bone marrow hematopoietic
function.

06 07
Lymphocytes Atlas of typical blood cells

The cells vary sharply in volume, with diameters ranging from 6 to 15 μm. A
physiological increase in lymphocytes may occur in children. A pathological
increase in lymphocytes is associated with certain infectious diseases
induced by viruses or bacteria, such as mumps or infectious mononucleosis,
chronic infections during recovery from tuberculosis, and acute and chronic
lymphocytic leukemia.

08 09
Monocytes Atlas of typical blood cells

Monocytes are large cells approximately 12–20 μm in diameter. They are A pathological increase in monocytes may be observed in infectious diseases
typically round, oval, or irregular in shape, with or without pseudopods. The such as subacute infective endocarditis, malaria, and Kala-azar (visceral
nucleus is twisted or irregularly folded and sometimes shaped like a kidney, leishmaniasis). It could also occur in the recovery phase of acute infections
mountain, or horseshoe. The nucleus chromatin is loose and reticulate and and certain hematological diseases, such as the recovery phase of
stained light violet-red. The cytoplasm is gray-blue or gray-red, translucent, agranulocytosis, monocytic leukemia, and MDS.
commonly vacuolated, and contains small, dust-like violet-red granules.

10 11
Eosinophils Atlas of typical blood cells

The cells are 13–15 μm in diameter, typically round, with a glasses-shaped Eosinophils are less capable of killing bacteria than neutrophils, and an
2-lobe nucleus and coarse and deep violet-red chromatin. The cytoplasm is increase in eosinophils can be observed in parasitic infections and certain
stained lightly and filled with coarse and neatly arranged orange granules, types of allergies.
which contain a variety of enzymes such as peroxidase, phospholipase D,
catalase, and acid phosphatase.

12 13
Basophils Atlas of typical blood cells

The cells are 10–12 μm in diameter, typically round, and the nucleus is An increase in basophils may occur in specific allergies, myeloproliferative
obscured by granules, which are violet-black, varied in sizes, and unevenly disorders, and basophilic leukemia.
distributed in the cells. The chromatin is coarse and violet-red, and the
cytoplasm is stained lightly.

14 15
Red Blood Cells and Platelets

Red blood cells: Normal red blood cells are biconcave disc-shaped,
relatively uniform in size, with an average diameter of 7.2 μm
(6.7–7.7 μm), They turn pink after Wright's staining,with the central
lightly stained area accounting for about 1/3 of the volume, and no
abnormal structures in the cytoplasm. Although normal red blood
cell shapes are typically seen in healthy individuals, they are also
visible in acute hemorrhagic anemia and some cases of aplastic
anemia.
Platelets: Normal platelets are about 1.5–3 μm in diameter. They
come with a slightly biconvex discoid structure, mostly round, oval,
or slightly regular, containing no nucleus. Tiny violet-red granules
are evenly distributed and clustered or dispersed in the cytoplasm,
which is usually light blue or light pink. Platelets are produced by
megakaryocytes in the bone marrow hematopoietic tissue and have
functions such as maintaining endothelial cell integrity, aggregation,
adhesion, release, procoagulation, and clot retraction.

16 17
 Neutrophil Phagocytosis of Fungi or Parasites

Neutrophils are the primary form of phagocytes with a strong ability to

migrate by deformation and high phagocytic activity.

Abnormal
Peripheral Blood Cells

19
Toxic Changes in Neutrophils Atlas of typical blood cells

In some severe septic infections, sepsis, extensive burns, malignant tumors,

acute poisoning, and other pathological conditions, neutrophils may present
various cell sizes, toxic granulation, vacuolation, Döhle bodies, and
degenerations. These changes may occur alone or together, and they are
helpful indications for disease monitor and prognosis.

20 21
Blast Cells Atlas of typical blood cells

Blasts are medium to large cells with high nuclear to cytoplasmic ratios. They
have prominent round or almost round nuclei containing fine-grained
chromatin and apparent nucleoli. They also have scant and basophilic
cytoplasm stained blue or dark blue.

22 23
Promyelocytes Atlas of typical blood cells

Promyelocytes are round or oval cells 12–25 um in diameter and larger than
myeloblasts. They have a large and slightly indented nucleus that usually
deviates to one side with a visible nucleolus, and the chromatin starts to
aggregate and is more coarse and clumped than myeloblasts. They have
abundant basophilic cytoplasm stained blue or dark blue and contain
violet-red or deep violet-red non-specific granules with variable numbers and
morphology and are unevenly distributed in the cytoplasm. A paranuclear
hof or cleared space may be present.

24 25
Abnormal Promyelocytes Atlas of typical blood cells

Typical abnormal promyelocytes vary in size, with irregular nuclei (generally APL is an acute myeloid leukemia with malignant proliferation of abnormal
kidney-shaped or bilobed), dense nuclear chromatin, occasional visible fuzzy promyelocytes and reproducible genetic abnormalities t(15;17)(q22;q12) and
nucleoli, abundant cytoplasm, and long and thick Auer rods (i.e. "faggot cells" PML-RARα with an aggressive clinical presentation. Any abnormal
since they resemble a bundle of sticks or a faggot). Based on the FAB promyelocytes found in the peripheral blood should be noted in the report
classification scheme as well as the characteristics of intracellular granules and notified to the clinician at the earliest time possible for the consideration
and the nuclear shape, acute promyelocytic leukemia (APL; AML-M3) was of APL possibility.
divided into three subtypes based on the characteristics of intracellular
granules and the nuclear shape: M3a (coarse granules), M3b (fine granules),
and M3v (micro or invisible granules and twisted or lobulated nuclei).

26 27
Neutrophilic Myelocytes Atlas of typical blood cells

Neutrophilic myelocytes are round cells 10–20 μm in diameter, smaller than Neutrophilic myelocytes could present in peripheral blood under conditions
promyelocytes. The nucleus is oval, semicircular, flattened or slightly Indented including AML, CLL, MDS, and severe infections.
on one side, and The indentation is usually less than 1/2 the nucleus
diameter when assuming it is round. The nucleus is normally anucleolate and
stained with concentrated clusters in the form of rods. The cytoplasm is
abundant and stained blue or light blue, and it is heavily filled with fine and
light red or violet-red granules.

28 29
Neutrophilic Metamyelocytes Atlas of typical blood cells

Neutrophilic metamyelocytes are round cells 10–16 μm in diameter. The

nucleus is significantly Indented and kidney-shaped, semilunar, or
horseshoe-shaped. The indentation is less than 1/2 the nucleus diameter and
1/2 to 3/4 the diameter of the nucleus when assuming it is round. The nucleus
is often eccentric and anucleolate, with chromatin aggregation in small clusters
and visible parachromatin. The cytoplasm is abundant, light blue and filled with
neutral granules. Neutrophilic Metamyelocytes could present in peripheral
blood under pathological conditions including AML, CLL, MDS, and severe
infections.

30 31
Reactive Lymphocytes Atlas of typical blood cells

Upon stimulation by viruses (e.g., adenovirus), protozoa (e.g., Toxoplasma The increase in reactive lymphocytes is typically seen in viral and allergic
gondii), drug reactions, connective tissue diseases, and other stimuli, diseases such as infectious mononucleosis, viral hepatitis, epidemic
lymphocytes may undergo proliferation and morphological changes such as hemorrhagic fever, and eczema.
cell swelling, increased, cytoplasm, enhanced basophilia, and nuclear
blastogenesis. Such lymphocytes are referred to as "reactive lymphocytes".
They fall into three types depending on the morphological characteristics.
Type I (vacuolated) is also known as foam cell or plasma cell type, type II
(irregular) as monocytic type, and type III (naive) as immature cell type or
prolymphocyte type.

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Abnormal Lymphocytes Atlas of typical blood cells

Abnormal lymphocytes, or atypical lymphocytes — suspected neoplastic are

often used to describe the lymphocytic changes due to suspected malignant
and monoclonal etiology. Abnormal lymphocytes are typically seen in
Malignancies such as leukemia and lymphoma. These cells tend to exhibit a
variable but highly homogeneous morphology in the blood of one patient,
making it difficult to distinguish them from reactive lymphocytes.Any
peripheral blood smear with suspected hairy cells, lymphoma cells, or
prolymphocytes for the first time can be reported as abnormal lymphocytes,
which is ultimately determined by flow cytometry immunophenotyping.

Sézary Cells Lymphoma Cells

Sézary cells are mature peripheral lymphoma T cells cells. They are Lymphoma cells are malignant cells originating from T, B, or NK cells. The cell
anucleated, vary in size, and comprise coarse and dense chromatin. The cells morphology is quite diverse and often exhibits the following characteristics:
have polymorphic nuclei that are twisted, deformed or lobulated, or folded The cells vary significantly in size with regular or irregular shapes, and The
like "brain gyrus", with scant cytoplasm in a blue or pale blue color. cells vary significantly in size with regular or irregular shapes, and the nucleus
is typically indented, twisted, folded, or has cut marks. the thickness of the
chromatin is variable, with or without nucleolus; the cytoplasm may be
abundant or scant, with a deep blue color, and sometimes with visible
granules and vacuoles.

34 35
Abnormal Lymphocytes Atlas of typical blood cells

Prolymphocytes Hairy Cells

Lymphoblasts or prolymphocytes are present in the peripheral blood.
Hairy cells are about two times larger than mature lymphocytes. The nucleus
Prolymphocytes are large cells, 12–14 μm in diameter, with medium amount
is round, oval, or indented and mildly folded. It is large and in the center of
of cytoplasm in a pale blue color and a decreased nuclear-cytoplasm ratio.
the cell or slightly deviated. Hairy cells have abundant cytoplasm with a blue
Their nucleus is generally round or oval with dense chromatin, either granular
or pale blue cloudy appearance. A prominent feature of hairy cells is the
or clumpy, coarser than that of lymphoblasts but finer than that of mature
uneven margins with many irregular ciliated protrusions, also called "hair-like"
lymphocytes. Typically, each prolymphocyte has a single large vesicular
protrusions, which are apparent when intravital staining is performed.
nucleolus. Prolymphocytes are typically seen in acute or chronic lymphocytic
Characteristic hairy cells are present in 90% of hairy cell leukemia. Hairy cells
leukemia, viral infections, and lymphocytic leukemoid reactions.
first identified in a blood smear should be counted as abnormal lymphocytes
and the morphological features should be described in detail.

36 37
Plasma Cells Atlas of typical blood cells

Mature plasma cells vary in size with diameters ranging from 8 to 15 μm. Plasma cells are generally not found in peripheral blood smears of healthy
They generally have a small and eccentric nucleus, which is round and individuals. A small number of abnormal plasma cells (myeloma cells) are
accounts for less than 1/3 of the volume. The chromatin is agglomerated into visible in the peripheral blood of patients with multiple myeloma. Typical
large blocks in which parachromatin is visible. The cells are anucleolate and myeloma cells are larger than mature plasma cells, irregular in shape, and
their cytoplasm is deep blue and opaque, often with numerous vacuoles may have pseudopods. The cells have a large nucleus, loose and delicate
(foamy cytoplasm). Typically, a distinct perinuclear halo area next to the chromatin, one to two large and obvious nucleoli, and abundant blue
nucleus is visible. cytoplasm. Abnormal plasma cells may also be found in the peripheral blood
of patients with plasma cell leukemia.

38 39
Abnormal Platelets Atlas of typical blood cells

Abnormalities of platelets may occur in size, morphology, aggregation, and

PLT Aggregation
distribution. In physiological conditions, there are 0.7% to 2.0% giant
platelets, 8% to 16% large platelets, 44% to 49% medium platelets, and 33% Platelets are usually distributed scattered in
to 44% small platelets . A low percentage of platelets with morphological anticoagulated blood smears. Platelet
abnormalities could be found in peripheral blood, such as rod-, tadpole-, or aggregations can result in spurious low platelet
snake-shaped platelets. Clinical abnormalities should be considered when counts using the impedance counting method
there are over 10% of irregular and bizarre platelets. Abnormal platelets can by hematology analyzers. The leading causes of
be found in MDS, granulocytic leukemia, post-splenectomy complications, platelet aggregation are thrombocythemia and
TTP, and giant platelet disorders. platelet activation because of myeloproliferative
neoplasms or improper blood sampling or
mixing methods. It could also be observed in
EDTA-PTCP blood samples because the
EDTA-dependent antibodies interact with
Gray Platelets platelet glycoproteins IIb/IIIa. Platelet
aggregations in EDTA-PTCP samples could be
The name “gray
resolved by re-collecting the blood sample in
platelet” derives from
tubes with non-EDTA anticoagulants (e.g., citrate)
the gray appearance
or using hematology analyzers with PLT
of the enlarged
deaggregation functions.
platelets under light
microscopy after
Wright's staining,
mainly caused by the
Large & Giant PLTs
reduction or absence Large platelets are usually 4–7 μm in diameter,
of platelet α granules similar to or slightly smaller than red blood cells.
and protein contents. Giant platelets are generally larger than red
These cells are blood cells, usually 7–20 m and sometimes > 20
commonly seen in m in diameter.. Their cytoplasm generally
gray platelet contains fine azurophilic granules or large fused
syndrome (GPS). The granules. Large and giant platelets are mainly
main clinical observed in ITP, MDS, Bernard-Soulier syndrome,
manifestation is mild Glanzmann thrombasthenia, and
to moderate bleeding, post-splenectomy complications. Increasing
which is often large and giant platelets can cause spurious low
accompanied by platelet counts when using the impedance
myelofibrosis and counting method by hematology analyzers.
splenomegaly.

40 41
Megakaryocytes Atlas of typical blood cells

Generally, megakaryocytes are not found in the peripheral blood of healthy Small megakaryocytes: Some of them are similar to lymphocytes in size (i.e.
individuals. Some pathological megakaryocytes characterized by abnormal lymph-like small megakaryocytes), with a diameter of 5–8 μm. They are
nuclei, such as small megakaryocytes, lymphoid megakaryocytes, and typically mononucleated and anucleolate, and round or oval in shape, with
binucleated megakaryocytes, can be observed in patients with acute scanty, pale blue cytoplasm that may contain a variable number of violet-red
megakaryocytic leukemia, MDS, MPN, MDS/MPN, AML and malignancies. granules.

42 43
Nucleated Red Blood Cells Atlas of typical blood cells

Nucleated red blood cells (nucleated erythrocytes, normoblasts, erythroblasts) The cells are generally regular, round or round-like, with verrucous protrusions
refer to red blood cells that undergo four stages, i.e., pronormoblasts, seen in pronormoblasts and basophilic normoblasts. The nucleus is round and
basophilic normoblasts, polychromatic normoblasts, and orthochromatic generally centered, and denucleation is observed in orthochromatic
normoblasts, before they develop into mature cells. normoblasts. The cytoplasm changes its color from deep blue blue-gray
gray-red pale red, and contains no granules.

44 45
Smudge Cells Artefacts

Smudge cells, also known as basket cells or Gumprecht shadows, are Improper staining procedures such as blood smear over-drying, inappropri-
remnants of leukocytes damaged during peripheral blood smear prepara- ate staining solution-to-buffer ratios, and/or insufficient washing could cause
tion. They are stained light violet-red and have a blurred chromatin structure. dye adherence, resulting in dye sediment formation. Artefacts could be
An increase of smudge cells in peripheral blood is associated with chronic effectively removed by dissolving the dry blood smears with methanol and
lymphocytic leukemia. rinsing them with water.

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MC-80
Automated Digital Cell Morphology Analyzer

More Clarity. More Intelligence. Displays the ultra clarity and authenticity of
each cell
More Productivity. More Clarity
Captures comprehensive pathological
features of each cell

Reliable cell pre-classification and

pre-characterization
More Intelligence
The intelligent analysis mode makes the process
easier and requires less manual intervention.

60 slides/h guarantees ultimate efficiency

Remote review and consultation in multiple

More Productivity locations

User-friendly and intuitive software

optimizes lab workflows
 Multi-layer fusion technology

Simulates manual focus adjustment and accurately restores the pathological

features of cells, which is helpful for early screening of blood diseases (such
as acute promyelocytic leukemia) and infectious diseases.

High-speed continuous
capturing

Fuses all images to

capture
concise pathological
features

Captures all details

with more than
20 depths of field
Flexible configuration options to meet
various needs

MC-80 can be connected with Mindray CAL-6000 or CAL-8000 cellular

analysis line for a complete solution

CAL 6000

• Width×Depth×Height: 2970×1030× 810 (mm)

CAL 8000

• Width×Depth×Height: 8240×1030×1470 (mm)