临床血液学检验技术课件正常血细胞形态（附中文）

NormalBloodCellMorphology正常血细胞形态广州医科大学附属第二医院王忠英Contents123GranulocyteseriesErythrocyteseriesMegakaryocyteseries粒细胞系统红细胞系统巨核细胞系统Myelo-髓、粒Erythro-红（red)Mono-单Lympho-淋巴Cyto-,-cyte细胞Karyo-核型Mega-巨、大Pro-前；meta-，后-philic亲...的，嗜...的blastcell母细胞、原始细胞MyelocyteMonocytecyteLymphoMegakaryocyteNewwords:cytoplasm细胞质myeloblast原始粒细胞nucleus细胞核promyelocyte早幼粒细胞nucleolus(nucleoli)核仁myelocyte中幼粒细胞chromatin染色质metamyelocyte晚幼粒细胞azurophilic嗜苯胺蓝的granulocyte粒细胞neutrophilic嗜中性的pronormoblast原始红细胞eosinophilic嗜酸性的normoblast早幼红细胞basophilic嗜碱的erythrocyte红细胞megakaryoblast原始巨核细胞promegakaryocyte幼巨核细胞megakaryocyte巨核细胞Hematopoiesis（血细胞生成）Howtoidentifyacell?Cell:size,shape,N:CNucleus(胞核):shape，location,chromatinpattern,nucleoli核：形状，位置，染色质模式，核仁Cytoplasm(胞浆):color,amount,granule,vacuole,inclusionbody细胞浆（cyto浆）：颜色，数量，颗粒，液泡，包涵体GeneraltrendsthataffectthemorphologyofbloodcellsduringthedevelopmentalprocessQuestion:①②③neutrophilicsegmented分叶granulocyteeosinophilicsegmentedgranulocytebasophilicgranulocyteGranulocyteseriesMyeloblast原粒细胞Promyelocyte早幼粒细胞NeutrophilicEosinophilicBasophilicMyelocyteMetamyelocyteStabgranulocyteSegmentedgranulocyte晚幼粒细胞杆状核粒细胞分叶核粒细胞中幼粒细胞Myeloblast原粒细胞Size:10-20μmindiameter,roundoroval直径10-20微米，圆形或椭圆形Neucleus:roundoroval,centraloreccentric,finechromatininreddish-purple,2-5obviousnucleoli圆形或椭圆形，居中或略偏位，染色质浅红紫色，核仁2-5个明显Cytoplasm:smallamount,transparentskyblueordeepblue,nogranuleorafew(typeⅡ)少量，透明天蓝或深蓝色，无颗粒或少数（Ⅱ型）Promyelocyte(progranulocyte)早幼粒细胞S:12-25μm,maybelargerthanmyeloblast,roundoroval12-25μm，可大于原粒，圆形或椭圆形N:roundorovalorslightlyindented,centraloreccentric,slightlycoarserchromatinpattern,nucleoli:oftenvisible圆形或椭圆形或略微锯齿状，中心或偏心，稍微粗糙的染色质模式，核仁：经常可见C:moderateorabundantinamount,containsafewormanyazurophilicgranuleswhicharevariableinsizeandshape,oftenovernucleus中等或丰富的量，含有少量或许多常常是尺寸和形状可变的天蓝色颗粒在核上NeutrophilicMyelocyte中性中幼粒细胞S:10-20μm,round,reductioninN:C圆形，N：C还原N:ovalorslightlydistorted,usuallyeccentric,chromatinpatternbecomescoarser,purpleincolor,withoutnucleoli椭圆形或轻微变形，通常偏心，染色模式变得粗糙，紫色，无核仁C:abundant,reddishorlightblue,pinkspecificsecondarygranulesmaybeseenaspinkishareasnearthenucleusfirst(barelyvisible)丰富，红色或浅蓝色，粉红色特定次生

颗粒可以看作是核附近的粉红色区域第一（几乎看不到）NeutrophilicMetamyelocyte中性晚幼粒细胞S:10to16μm,round10〜16μm，圆形N:kidneyorhorseshoeshaped,eccentric,withcoarserchromatinpattern,vice-chromatin（副染色质）appears肾或马蹄形，偏心，粗糙,染色质模式，副染色质出现C:abundant,reddish,fullofpinkneutrophilicgranules丰富，红色，充满粉红色中性粒细胞Neutrophilic

Stabgranulocyte中性杆状核粒细胞S:10to15μm,round10〜15μm，圆形N:bandshaped,U-shaped,S-shaped,coarsechromatin,distinctvice-chromatin带状，U形，S形，粗染色质，明显的副染色质C:sameasthemetamyelocyteNeutrophilicSegmentedGranulocyte

中性分叶核粒细胞S:10to14μm,roundN:usually2to5lobes,connectedbyfilamentsstrandofheterochromatin,coarseclumpedchromatinpattern.通常2至5个裂片，通过细丝连接异染色质链，粗团块染色质模式。C:abundantinreddishwithafullcomplementofrose-violetspecificgranules丰富，带红色带满补充玫瑰紫特定颗粒4kindsofgranules(颗粒)ingranulocytesANeutroEosinoBasoazurophilicdifferentnumber﹠size,irregularlyshaped,oftenovernucleus嗜苯胺蓝不同数量和大小，不规则成形，经常结束核neutrophilicsmaller,finer,barelyVisible嗜中性更小，更细，仅仅可见eosinophilicnumerous,large,uniform,evenlydistributed,suffusingCytoplasm嗜酸性众多，大，均匀，均匀分散式，饱满细胞质basophilicfew,large,irregularshape,variableinsize,unevenlydistributed,oftenovernucleus嗜碱少，大，不规则形状，尺寸可变，不均匀分散式，经常在核上Myeloidmaturationsequence骨髓成熟序列question:RBCErythrocytepronormoblast原始红细胞early(basophilic)normoblast早幼红细胞polychromaticnormoblast中幼红细胞orthochromaticnormoblast晚幼红细胞reticulocyte网织红细胞erythrocyte(RBC)红细胞ErythrocyteseriesPronormoblast（原始红细胞）S:15-25μm，sometimespseudopod（伪足）N:Roundtoslightlyoval,central,granulouschromatinstainedreddish-purple,1-3bluishnucleoli圆形到略呈椭圆形，中心，颗粒状染色质染红紫色，1-3蓝色核仁C:moderatein

amount,darkblueincolorandopaque,showingtumor-likeprotrusionandadistinctperinuclearpalezone,nogranules数量适中，深蓝色不透明，显示肿瘤样突起和明显的核周苍白区，无颗粒Earlynormoblast（早幼红细胞）S:10-18μm,roundorovalN:round,central

chromatinpatternslightlycondensednucleoliarepresent,butnotalwaysvisible圆形，中心染色质模式略浓缩,核仁存在，但不总是可见的C:moderateinamount,intenselyblueandopaque,perinuclearpalezoneisvisible中等量，强烈蓝色和不透明，核周白色区是可见的Polychromaticnormoblast（中幼红细胞）S:8-15μm,roundN:smaller,round,central,chromatinpatternmorecondenseindeeppurplewithdistinctvice-chromatin,givingacartwheel-shapedappearance.nucleoliabsent较小，圆形，中心，染色质模式在深紫色更浓缩，具有明显的副染色质，呈现卡车形外观。核仁缺失C:abundantinquantity,polychromatic数量丰富，多色Orthochromaticnormoblast（晚幼红细胞）S:7-10μm,roundN:round,centraloreccentric,pyknoticchromatinpatterninblackpurple,vice-chromatinmayvisibleorinvisible,sometimesextrusion圆形，中心或偏心，黑色紫色的固缩染色质图案，副染色质可见或不可见，有时挤出C:abundantinquantity,pinkerthanpreviousstage数量丰富，比上一阶段更粉红Reticulocyte（网织红细胞）largerthanmatureredcellcontainssomeRNAremnants,polychromaticincolor包含一些RNA残留物，多色的颜色Erythrocyte（红细胞）6-8μmindiameter,7.2μmonaverage,

biconcavedisk,asmallareaofcentralpallor,anuclear,pink直径6-8μm，平均7.2μm，双凹面盘，小面积的中心苍白，无核，粉红色Erythroidmaturationsequence类红细胞成熟序列stagesofmegakaryocyticmaturation:megakaryoblast（原始巨核细胞）promegakaryocyte（幼稚巨核细胞）granularmegakaryocyte（颗粒型巨核细胞）thrombocytopoieticmegakaryocyte(产血小板型巨核细胞)nakedmegakaryocyte（裸核型巨核细胞）platelet（血小板）Megakaryocyteseries

Megakaryocytopoiesisdevelopmentoccursbyendomitosis巨核细胞生成发生通过内吞Megakaryoblast（原始巨核细胞）S:15-30μm,roundorirregularN:large,roundorirregular.coarsereticularchromatininpurple,2-3vaguenucleoli大，圆形或不规则。粗网状染色质紫色，2-3模糊核仁C:smalltomoderatecytoplasmindeepblue,mayhavepseudopod,nogranules小到中等的细胞质在深蓝色，可能有pseudopod，没有颗粒Promegakaryocyte（幼稚巨核细胞）S:30-50μm,irregularN:irregularinshape,mayshowslightlobulation,

coarserchromatin,nucleoliindistinct形状不规则，可能显示轻微的鳞裂，较粗的染色质，核仁不清晰C:moreamountcytoplasmindeepblue,reddish-purplegranulesvisible,pseudopodvisible更多量的细胞质在深蓝色，红紫色颗粒可见，伪足可见Granularmegakaryocyte（颗粒型巨核细胞）S:giant,

40-70μm,integritymembrane完整膜N:giant,

multiplenucleiormulti-lobulation,coarserpatchychromatinpattern巨大，多核或多叶，更粗糙的斑状染色质模式C:veryplentifulcytoplasmfullofpurplegranules非常丰富的细胞质充满紫色颗粒Thrombopoieticmegakaryocyte（产血小板型巨核细胞）S:40-70μm,irregular,blurredmembrane模糊膜N:giant,hyperploidnucleioftenoverliewithclumpedchromatin巨大的，超倍体核常常覆盖有结块的染色质C:veryplentifulcytoplasminreddish,granulesclusterandbudofftobecomeplatelet非常丰富的细胞质，红色，颗粒簇和芽脱落成为血小板PNaked

megakaryocyte（裸核型巨核细胞）Amaturemegakaryocyticnucleuswithoutcytoplasm成熟巨核细胞核无细胞质Platelet1–4µmindiameter,givingastar-likeappearance,a