Okay, that was disturbing. But it was a lot of fun making cookies in the shape of different blood cells for our lectures on anemia and leukemia this week!
The colors didn’t always turn out very appetizing – I was going for realness, though, and I think I nailed it! Thanks for being so sweet and eating up almost all of the cookies! I took the rest to the dean’s office – thought they could use a little treat up there. Shall we review our different hematopathologic diseases? I think we shall.
Here’s sickle cell anemia, with sickle cells (obviously), and a post-splenectomy blood picture including target cells, spherocytes, Howell-Jolly bodies, nucleated red cells, and a thrombocytosis. Basically, everything that the spleen normally filters from the blood – nucleated red cells, Howell-Jolly bodies, Pappenheimer bodies (which are little iron granules), target cells, and spherocytes – gets out into the blood when you don’t have a spleen. The spleen also holds about 1/3 of your platelets at any given time – so removing the spleen removes their little home, and they have to wander the streets (blood vessels), begging for food. So sad.
Here we have helmet cells, spherocytes, and the most specific (but unimaginatively-named) schistocyte of all: the triangulocyte.
In this one, you’ve got oval macrocytes (gigantic, oval-shaped red cells) and hypersegmented neutrophils.
Here we have a neutrophilic leukocytosis with a left shift (there’s a myelocyte, top left, a metamyelocyte, bottom left, and a promyelocyte, center) and a basophilia (right). Check out how mature the chromatin is in the myelocyte, metamyelocyte, and segmented neutrophil – but how fine it is (you can even see nucleoli!) in the promyelocyte). Also, the granules in the promyelocyte are in the cytoplasm and over the nucleus as well. The basophil granules are kinda obscuring the nucleus, but that’s what happens in real life, so we’ll call it artistic rendering.
Myeloblast with Auer rod
Not so appetizing, color-wise, but pretty accurate, microscope-wise. Check out the Auer rod next to the nucleus (which, by the way has such fine chromatin that you can see nucleoli through it). The Auer rod is a linear aggregation of primary (azurophilic) granules that only happens in malignant myeloblasts.
No, we’re not using the term that way – we’re talking about the old English for “bundle of sticks” (which is where the British slang for a cigarette, “fag,” came from). There are a TON of Auer rods in faggot cells – way more than I could draw here.
Chronic lymphocytic leukemia
In chronic lymphocytic leukemia, the lymphocytes are small, with clumped chromatin and not much else going on. They look like regular old mature lymphocytes. So I thought they deserved a light dusting of sprinkles. Not particularly appropriate histologically, but cute.
Here’s some of the cookies in the classroom (the Reed Sternberg cells were a big hit, so that tray’s already empty).
And here’s a shot of part of the craziness at the frosting stage. It was one of those projects that kind of scaled up in size very quickly! This is about 1/3 of all of the cookies…
- Kristine said Hi Cynthia – Yes!! I totally agree. I remember learning that if you see any secondary granulat...
- Cynthia said I’m going to have agree with the granules being the most important. I’m also MT and I...
- AG said Thanks Kristine, very helpful!
- Frank MD said Succinctly explained. Excellent! Thank you so much!!
- kartik said Thanks,i am learner,when i think hypothtically,i think i may find confusing beetween promyelocyte an...
- Carol said Thanks…. Well explained
- Ulyses Yakovlevich said This looks like an awesome tool for future Pathologists to learn from :).
- Chief said Amazing explanation. No other website teaches this interesting and important medical lesson. Not eve...
- Dr.Kisor Kumar Pal said Very helpful and practical discussion.I learned a lot.
- Cheri said Thank you ! I’m a traveler in Pathology/Histology
- Dr. Syed Mahbub Baksh said During my residency years, I have read only two books: Robbins Pathology and Henry’s Clinical...
- Theresa said Thanks for breaking this down in a simple way to understand it. Well done.