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9 Lymphocyte maturation

FIGURE 9–1 Lymphocyte sequence—B and T lymphoblasts.

Lymphoblast

FIGURE 9–2A Lymphoblast.

FIGURE 9–2B Schematic of lymphoblast.

FIGURE 9–2C Electron micrograph of lymphoblast (×28,750). Lymphoblasts are difficult to distinguish morphologically in normal bone marrow.

Size:

10-20 μm

Nucleus:

Round to oval

Nucleoli:

≥1

Chromatin:

Fine, evenly stained

Cytoplasm:

Scant; slightly to moderately basophilic

Granules:

None

N/C RATIO:

7:1 to 4:1

Reference interval:

Bone marrow:

Not defined

Peripheral blood:

0%

FIGURE 9–3 Lymphocyte sequence—B and T prolymphocytes.

Prolymphocyte

FIGURE 9–4A Prolymphocyte.

FIGURE 9–4B Schematic of prolymphocyte. Prolymphocytes are difficult to distinguish morphologically in normal bone marrow.

Size:

9-18 μm

Nucleus:

Round or indented

Nucleoli:

0-1; usually single, prominent, large nucleolus

Chromatin:

Slightly clumped; intermediate between lymphoblast and mature lymphocyte

Cytoplasm:

Light blue

Granules:

None

N/C RATIO:

3-4:1

Reference interval:

Bone marrow:

Not defined

Peripheral blood:

None

FIGURE 9–5 Lymphocyte sequence—B and T lymphocytes. (NOTE: T lymphocytes cannot be distinguished from B lymphocytes with Wright stain.)

Lymphocyte

FIGURE 9–6A Small lymphocyte.

FIGURE 9–6B Schematic of lymphocyte.

FIGURE 9–6C Large lymphocyte. Note irregular nucleus and more abundant cytoplasm than small lymphocyte.

FIGURE 9–6D Large granular lymphocyte. Note prominent azurophilic granules in cytoplasm.

FIGURE 9–6E Electron micrograph of lymphocyte (×30,000).

Size:

7-18 μm

Nucleus:

Round to oval; may be slightly indented

Nucleoli:

Occasional

Chromatin:

Condensed; clumped; blocky, smudged

Cytoplasm:

Scant to moderate; sky blue; vacuoles may be present

Granules:

None in small lymphocyte; may be a few azurophilic in larger lymphocytes; if granules are prominent, the cell is called a large granular lymphocyte.

N/C RATIO:

5:1 to 2:1

Reference interval (for combined small and large lymphocytes):

Bone marrow:

5% to 15%

Peripheral blood:

20% to 40%

Refer to Table 1-1 for more examples.

FIGURE 9–7 Lymphocyte sequence—plasma cell.

Plasma cell

FIGURE 9–8A Plasma cell.

FIGURE 9–8B Schematic of plasma cell.

FIGURE 9–8C Electron micrograph of plasma cell (×17,500).

Size:

8-20 μm

Nucleus:

Round or oval; eccentric

Nucleoli:

None

Chromatin:

Coarse

Cytoplasm:

Deeply basophilic, often with perinuclear clear zone (hof)

Granules:

None

Vacuoles:

None to several

N/C RATIO:

2:1 to 1:1

Reference interval:

Bone marrow:

0% to 1%

Peripheral blood:

0%

FIGURE 9–9 Lymphocyte sequence with (A) lymphoblast, (B) prolymphocyte, (C) lymphocyte, and (D) plasma cell.

All photomicrographs are ×1000 original magnification with Wright-Giemsa staining unless stated otherwise.

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9 Lymphocyte maturation

FIGURE 9–1 Lymphocyte sequence—B and T lymphoblasts.

Lymphoblast

FIGURE 9–2A Lymphoblast.

FIGURE 9–2B Schematic of lymphoblast.

FIGURE 9–2C Electron micrograph of lymphoblast (×28,750). Lymphoblasts are difficult to distinguish morphologically in normal bone marrow.

Size:

10-20 μm

Nucleus:

Round to oval

Nucleoli:

≥1

Chromatin:

Fine, evenly stained

Cytoplasm:

Scant; slightly to moderately basophilic

Granules:

None

N/C RATIO:

7:1 to 4:1

Reference interval:

Bone marrow:

Not defined

Peripheral blood:

0%

FIGURE 9–3 Lymphocyte sequence—B and T prolymphocytes.

Prolymphocyte

FIGURE 9–4A Prolymphocyte.

FIGURE 9–4B Schematic of prolymphocyte. Prolymphocytes are difficult to distinguish morphologically in normal bone marrow.

Size:

9-18 μm

Nucleus:

Round or indented

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Clinical Hematology Atlas