Hematology Lec

Introduction to Hematology and Hematologic Terms | Vanessa Lee Calimbo

Introduction to Clinical Hematology

1.) Hematology
a.) Branch of medicine that deals with
the study of blood, its composition,
function of the blood cells, the
morphology and physiology of
blood cells, and diseases or
disorders related to blood
b.) Hema / Haima / Hemato - “Blood”
c.) Logy / Logos - “Study of”
2.) History of Clinical Hematology
a.) Athanasius Kircher (1657)
i.) Known for his work on
Scrutinium Pestis
ii.) During the 17th century, a
part of the world b.) Anton van Leeuwenhoek (1674)
(particularly Europe) i.) Dutch
experienced the Bubonic ii.) Known for his work on
plague single lens microscope
(1) Bubonic plague iii.) He was interested in
was caused by a obtaining samples from the
bacterium environment (e.g. rain
iii.) 1646 water, pond water, etc.)
(1) Using a iv.) He used the single lens
microscope, he microscope to look at these
obtained samples samples and that is where
from the plague he observed the
victims single-celled
iv.) 1658 microorganisms which are
(1) Through his work the protozoa for the first
“Scrutinium Pestis” time
he found out that v.) His single lens microscope
“little worms” or paved the way for more
“animalcules” in the development in
blood samples of microscopes
the victims Picture of Anton van Leeuwenhoek:
(2) He concluded that
there must be
something that is
causing the disease
(3) The information
and observations
of Kircher was
noted in his work
“Scrutinium Pestis”
v.) Proposed hygienic
measures, isolation,
quarantine, burning clothes
worn by the infected, and
wearing facemasks
Picture of Athanasius Kircher: c.) Giulio Bizzozero (late 1800’s)
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 i.) Italian pathologist (1) Useful in
ii.) Discovered: differentiating
(1) H. pylori leukocytes in blood
(2) Function of (2) The Wright stain is
platelets actually a
iii.) He observed circulating modification of the
blood of living animals and Romanowsky stain
also blood that were v.) Also known for his
removed from the blood discovery of the origin of
vessels platelets
(1) There he noticed (1) He identified that
platelets and platelets originated
carefully described from
the function of megakaryocytes
platelets in the (2) Won the Boylston
flowing conditions. Medical Prize in
And also the 1908 for his
relationship discovery on the
between the origin of platelets
platelet adhesion, vi.) Other contributions
platelet (1) He was able to
aggregation, and demonstrate
fibrin formation spirochetes in the
Picture of Giulio Bizzozero: sample
(a) Spirochete
s are spiral
bacteria
(b) He saw this
in a patient
with
Syphilitic
aneurysm
(2)
Picture of James Homer Wright:

d.) James Homer Wright (1902)

i.) Doctor
ii.) Used to work at the
Pathology laboratory at the
Massachusetts General
Hospital
iii.) 1902 modification of
Romanowsky stain (Wright
Stain)
iv.) Known for his discovery of
an important hematological
stain which was named as
Picture of a blood smear stained with Wright Stain:
Wright Stain after him

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 waste products
from other tissues
Picture of Arterial vs Venous blood:

d.) Functions of Blood

3.) Blood i.) Respiration
a.) Type of tissue (1) Transports gasses
b.) Nutritive fluid to and from the
i.) This makes it unique from tissues and lungs
other tissues as it is fluid in ii.) Nutrition
form (1) Transports
c.) Participates in the physiologic and nutrients to
pathologic activities of the body different tissues
i.) Arterial blood - bright red iii.) Excretion
(1) Carries oxygenated (1) Bringing waste
blood (“clean products to the
blood”) kidneys and liver
(2) Obtained in the which filters and
arteries cleans the blood
(3) Only MTs that are iv.) Homeostasis
trained for arterial (1) E.g. forming blood
blood collection clots to prevent
can perform this blood loss
procedure v.) Body Protection
(a) It is usually (1) E.g. immunity
the (2) Carries cells for
Respiratory immunity (e.g.
Therapist’s WBC)
job to vi.) Transport
perform, e.) Characteristics of Blood
however i.) Fluid in vivo
some (1) In vivo - inside the
hospitals body
do not (2) Once outside the
have RTs. body, it starts to
In these clot
cases, ii.) Red in color
trained MTs iii.) Thick and viscous
will do iv.) Slightly alkaline (pH 7.35 -
ii.) Venous blood - dark red 7.45)
(1) Carries v.) S.G. (specific gravity /
deoxygenated density) 1.045 - 1.065
blood and also the vi.) 7-8% of the total body
weight
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 vii.) Total Volume (normal
(1) Male - 5-6L platelet
(2) Female - 4-5L count)
f.) Composition of Blood Things to note:
i.) Liquid (Plasma / Serum) Normal reference range may differ from textbook to
(55%) textbook
(1) Plasma - liquid Picture of the composition of blood:
portion of unclotted
blood
(2) Serum - liquid
portion of clotted
blood
(3) Water (91.5%)
(4) Chemicals
(a) Proteins
(7%)
(b) Others
(1.5%)
4.) Granulocytes and Agranulocytes
(electrolyte
a.) WBCs can be classified into two
s, NPN,
groups depending on the presence
hormones
of granules in their cytoplasm
and
b.) Granulocytes (with granules) /
enzymes,
Granular WBCs
and food
i.) Basophils → Mast Cells
materials)
(1) 0.5 - 1%
ii.) Solid / Cellular Components
(2) Associated with
(1) RBC
allergic reactions
(a) 45% of
(3) Contains large or
blood
coarse granules
volume
(4) Blue to black
(b) 4.5 - 6.5 x
granules
1012 / L
ii.) Eosinophils
(normal
(1) 2 - 4%
RBC count)
(2) Associated with
(c) Has
allergic reactions
hemoglobi
and parasitic
n which is
infections
also a
(3) Color of granules
pigment
vary from different
that gives
textbooks:
it its red
(a) Orange -
color
pink
(2) WBC
(b) Reddish
(a) 4 - 11 x 109
orange
/L (normal
(c) Pinkish red
WBC
iii.) Neutrophils
count)
(1) 60 - 70%
(b) Granular
(2) Associated with
and
bacterial infection
Agranular
(3) Color of granules
(3) Platelets
vary from different
(a) 150 - 350 x
textbooks:
109 / L
(a) Tan
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 (b) Lilac granules or toxic
(c) Light pink granulation
to bluish c.) Evaluation of cellular development
purple and formation (particularly from a
(usual BM sample)
color) i.) It is not the MTs that are
c.) Agranulocytes (without granules) usually tasked to examine
i.) Lymphocytes BM samples, instead its the
(1) 20 - 25% Hematology doctors
(2) Associated with ii.) As far as bone marrows are
immunity and viral concerned, MTs only assist
infection the hematologists during
(3) Has a big nucleus collection and to prepare
(4) Smallest WBC the bone marrow sample
(5) T cells (e.g. smearing and staining)
(6) B cells iii.) It is also not the MTs who
ii.) Monocytes → Macrophages do the BM collection, it is
(1) 3 - 8% the hematologists (as it is
(2) Associated more quite the invasive
with phagocytic procedure)
functions and d.) Evaluation of hemostatic function
chronic infections i.) Something to do with
(months or years) hemostasis
Picture of different WBCs: e.) Specimen collection and
preparation for exam
f.) Quantitative manual and
instrumental measurement of cells
i.) E.g. CBC
ii.) Either done manually or
with the use of machines
g.) Measurement of cell volumes
h.) Evaluation of cellular contents and
components
i.) Cellular identification
i.) After identifying, the cells
are counted (WBC) to know
if the count is normal or
5.) Services offered by Hema and Hemostasis
abnormal
Lab
6.) Common prefixes used in the vocabulary of
Things to note:
Hematology
Hemostasis Lab is still part of the Hematology Lab
Things to note:
but it is just a specialized lab for coagulation and
There are more but these are the most common
hemostasis
a.) A- / An-
a.) Identification of reactive or
i.) Lack, without
neoplastic alterations of cell
ii.) Absent, decreased
populations
iii.) E.g. Aplasia, Aplastic
i.) Neoplastic cells = tumor
anemia
b.) Evaluation of leukocytes,
b.) Aniso-
erythrocytes, and platelet function
i.) Unequal
i.) E.g. observation of
ii.) Dissimilar
abnormal morphology of
iii.) E.g. Anisocytosis (abnormal
any WBC such as
variation in size)
neutrophils with too much
Picture of a blood smear showing Anisocytosis:

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 i.) Beneath, under
ii.) Deficient, decreased
m.) Iso-
i.) Equal, alike
ii.) Same
iii.) E.g. Isotonic solution
n.) Leuko-
i.) White
ii.) E.g. Leukocyte (white cell)
o.) Macro-
i.) Large
ii.) Long
iii.) E.g. Macrophage
p.) Mal-
c.) Ante-
i.) Bad, abnormal
i.) Before
ii.) E.g. Malabsorption,
ii.) E.g. Ante-mortem (before
Malformation
death)
q.) Mega-
d.) Brady-
i.) Large
i.) Slow
ii.) Giant
ii.) E.g. Bradycardia (slow heart
iii.) E.g. Megakaryocyte,
rate)
Megaloblast
e.) Cyto-
r.) Meta-
i.) Cell
i.) After, next
ii.) E.g. Cytology
ii.) Change
f.) Dia-
iii.) E.g. Metaplasia
i.) Through, throughout,
(transformation from 1
during, across
adult cell type to another)
ii.) E.g. Dialysis (removal of
s.) Mono-
waste in the blood
i.) One
THROUGH a machine),
ii.) E.g. Monocyte
Diagnosis
t.) Morph-
g.) Dys-
i.) Shape or form
i.) Abnormal
ii.) E.g. Morphology
ii.) Difficult, bad
u.) Myel(o)-
iii.) Pain
i.) From the BM or Spinal cord
iv.) E.g. Dysplasia (abnormal
ii.) E.g. Myelogenous (refers to
development), Dysuria
a condition or disease of
(pain in urination)
the blood-forming cells in
h.) Erythro-
the BM), Myeloma
i.) Red
(malignant cancer of
ii.) E.g. Erythrocyte (red cell)
plasma cells)
i.) Ferr-
v.) Pan-
i.) Iron
i.) All, overall
j.) Hemo-
ii.) All-inclusive
i.) Pertaining to blood
iii.) E.g. Pancytopenia
k.) Hyper-
(condition where all blood
i.) Above, beyond
cells (RBC, WBC, Plt) are
ii.) Extreme
decreased in number) (is a
iii.) E.g. Hyperchromic
hematologic characteristic
(increased red color
of Aplastic Anemia)
intensity = increased
w.) Phleb-
hemoglobin)
i.) Vein
l.) Hypo-
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 ii.) E.g. Phlebotomy, Phlebitis aa.) Scler-
(inflammation of veins) i.) Hard
x.) Phago- ii.) E.g. Sclerotic
i.) Eat bb.) Splen-
ii.) Ingest i.) Spleen
iii.) E.g. Phagocytosis ii.) E.g. Splenectomy (removal
y.) Poikilo- of spleen)
i.) Varied cc.) Thromb(o)-
ii.) Irregular i.) Clot
iii.) Sometimes is associated ii.) Thrombus
with Anisocytosis and is iii.) E.g. Thrombosis
also sometimes confused dd.) Xanth-
with it i.) Yellow
(1) Poikilocytosis is the 7.) Common suffixes used in the vocabulary of
abnormal variation Hematology:
in shape, unlike a.) -blast
Anisocytosis which i.) Primitive
is the abnormal ii.) E.g. Erythroblast (younger /
variation in size primitive form of RBC),
iv.) E.g. Poikilocytosis Leukoblast
(abnormal variation in b.) -cyte
shape) i.) Cell
Picture of Poikilocytosis: c.) -ectomy
i.) Excision
ii.) Cut out
iii.) E.g. Splenectomy (removal
of spleen)
d.) -emia
i.) Blood
e.) -itis
i.) Inflammation
ii.) E.g. Phlebitis, Appendicitis
f.) -lysis
i.) Destruction
ii.) Dissolving
iii.) E.g. Autolysis, Cell lysis
g.) -(o)logy
Picture of Poikilocytosis vs Anisocytosis: i.) Study of
h.) -oma
i.) Swelling
ii.) Tumor
iii.) E.g. Sarcoma (malignant
tumor of the muscles),
Carcinoma (malignant /
tumor that is epithelial in
origin)
i.) -opathy
i.) Disease
ii.) E.g. Neuropathy
j.) -osis
z.) Schis- i.) State, condition
i.) Split ii.) Increase
ii.) E.g. Schistocytes

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 iii.) E.g. Stenosis (stagnation of
blood flow)
k.) -penia
i.) Decrease
ii.) Lack of
iii.) E.g. Pancytopenia,
Neutropenia (decrease in
neutrophils)
l.) -phil(ic)
i.) Attracted to
ii.) Affinity for
iii.) E.g. Hydrophilic
m.) -plasia (-plastic)
i.) -plasia is noun; -plastic is
adjective
ii.) Cell production or repair
n.) -poiesis
i.) Cell production
ii.) Formation, development
iii.) E.g. Hematopoiesis
o.) -poietin
i.) Stimulates production
ii.) E.g. Erythropoietin
(hormone that stimulates
erythrocytes)
p.) -stasis
i.) Same
ii.) Standing still
iii.) Can also mean stopping or
cessation
iv.) E.g. Homeostasis, Stenosis
(idk, sabi ni maam sa
vidlec)
q.) -trophy
i.) Nourishment
ii.) E.g. Trophic factors
8.) Examples of Hematologic Terms
a.) Anisocytosis
i.) An + iso + cyt + osis
b.) Aplasia
i.) A + plasia
c.) Anemia
i.) An + emia
d.) Dysmyelopoiesis
i.) Dys + myelo + poiesis
e.) Panmyelosis
i.) Pan + myel(o) + osis