NormalBloodCellMorphology正常血細胞形態廣州醫科大學附屬第二醫院王忠英Contents123GranulocyteseriesErythrocyteseriesMegakaryocyteseries粒細胞系統紅細胞系統巨核細胞系統Myelo-髓、粒Erythro-紅（red)Mono-單Lympho-淋巴Cyto-,-cyte細胞Karyo-核型Mega-巨、大Pro-前；meta-，后-philic親...的，嗜...的blastcell母細胞、原始細胞MyelocyteMonocytecyteLymphoMegakaryocyteNewwords:cytoplasm細胞質myeloblast原始粒細胞nucleus細胞核promyelocyte早幼粒細胞nucleolus(nucleoli)核仁myelocyte中幼粒細胞chromatin染色質metamyelocyte晚幼粒細胞azurophilic嗜苯胺藍的granulocyte粒細胞neutrophilic嗜中性的pronormoblast原始紅細胞eosinophilic嗜酸性的normoblast早幼紅細胞basophilic嗜堿的erythrocyte紅細胞megakaryoblast原始巨核細胞promegakaryocyte幼巨核細胞megakaryocyte巨核細胞Hematopoiesis（血細胞生成）Howtoidentifyacell?Cell:size,shape,N:CNucleus(胞核):shape，location,chromatinpattern,nucleoli核：形狀，位置，染色質模式，核仁Cytoplasm(胞漿):color,amount,granule,vacuole,inclusionbody細胞漿（cyto漿）：顏色，數量，顆粒，液泡，包涵體GeneraltrendsthataffectthemorphologyofbloodcellsduringthedevelopmentalprocessQuestion:①②③neutrophilicsegmented分葉granulocyteeosinophilicsegmentedgranulocytebasophilicgranulocyteGranulocyteseriesMyeloblast原粒細胞Promyelocyte早幼粒細胞NeutrophilicEosinophilicBasophilicMyelocyteMetamyelocyteStabgranulocyteSegmentedgranulocyte晚幼粒細胞桿狀核粒細胞分葉核粒細胞中幼粒細胞Myeloblast原粒細胞Size:10-20μmindiameter,roundoroval直徑10-20微米，圓形或橢圓形Neucleus:roundoroval,centraloreccentric,finechromatininreddish-purple,2-5obviousnucleoli圓形或橢圓形，居中或略偏位，染色質淺紅紫色，核仁2-5個明顯Cytoplasm:smallamount,transparentskyblueordeepblue,nogranuleorafew(typeⅡ)少量，透明天藍或深藍色，無顆粒或少數（Ⅱ型）Promyelocyte(progranulocyte)早幼粒細胞S:12-25μm,maybelargerthanmyeloblast,roundoroval12-25μm，可大于原粒，圓形或橢圓形N:roundorovalorslightlyindented,centraloreccentric,slightlycoarserchromatinpattern,nucleoli:oftenvisible圓形或橢圓形或略微鋸齒狀，中心或偏心，稍微粗糙的染色質模式，核仁：經常可見C:moderateorabundantinamount,containsafewormanyazurophilicgranuleswhicharevariableinsizeandshape,oftenovernucleus中等或豐富的量，含有少量或許多常常是尺寸和形狀可變的天藍色顆粒在核上NeutrophilicMyelocyte中性中幼粒細胞S:10-20μm,round,reductioninN:C圓形，N：C還原N:ovalorslightlydistorted,usuallyeccentric,chromatinpatternbecomescoarser,purpleincolor,withoutnucleoli橢圓形或輕微變形，通常偏心，染色模式變得粗糙，紫色，無核仁C:abundant,reddishorlightblue,pinkspecificsecondarygranulesmaybeseenaspinkishareasnearthenucleusfirst(barelyvisible)豐富，紅色或淺藍色，粉紅色特定次生

顆粒可以看作是核附近的粉紅色區域第一（幾乎看不到）NeutrophilicMetamyelocyte中性晚幼粒細胞S:10to16μm,round10?16μm，圓形N:kidneyorhorseshoeshaped,eccentric,withcoarserchromatinpattern,vice-chromatin（副染色質）appears腎或馬蹄形，偏心，粗糙,染色質模式，副染色質出現C:abundant,reddish,fullofpinkneutrophilicgranules豐富，紅色，充滿粉紅色中性粒細胞Neutrophilic

Stabgranulocyte中性桿狀核粒細胞S:10to15μm,round10?15μm，圓形N:bandshaped,U-shaped,S-shaped,coarsechromatin,distinctvice-chromatin帶狀，U形，S形，粗染色質，明顯的副染色質C:sameasthemetamyelocyteNeutrophilicSegmentedGranulocyte

中性分葉核粒細胞S:10to14μm,roundN:usually2to5lobes,connectedbyfilamentsstrandofheterochromatin,coarseclumpedchromatinpattern.通常2至5個裂片，通過細絲連接異染色質鏈，粗團塊染色質模式。C:abundantinreddishwithafullcomplementofrose-violetspecificgranules豐富，帶紅色帶滿補充玫瑰紫特定顆粒4kindsofgranules(顆粒)ingranulocytesANeutroEosinoBasoazurophilicdifferentnumber﹠size,irregularlyshaped,oftenovernucleus嗜苯胺藍不同數量和大小，不規則成形，經常結束核neutrophilicsmaller,finer,barelyVisible嗜中性更小，更細，僅僅可見eosinophilicnumerous,large,uniform,evenlydistributed,suffusingCytoplasm嗜酸性眾多，大，均勻，均勻分散式，飽滿細胞質basophilicfew,large,irregularshape,variableinsize,unevenlydistributed,oftenovernucleus嗜堿少，大，不規則形狀，尺寸可變，不均勻分散式，經常在核上Myeloidmaturationsequence骨髓成熟序列question:RBCErythrocytepronormoblast原始紅細胞early(basophilic)normoblast早幼紅細胞polychromaticnormoblast中幼紅細胞orthochromaticnormoblast晚幼紅細胞reticulocyte網織紅細胞erythrocyte(RBC)紅細胞ErythrocyteseriesPronormoblast（原始紅細胞）S:15-25μm，sometimespseudopod（偽足）N:Roundtoslightlyoval,central,granulouschromatinstainedreddish-purple,1-3bluishnucleoli圓形到略呈橢圓形，中心，顆粒狀染色質染紅紫色，1-3藍色核仁C:moderatein

amount,darkblueincolorandopaque,showingtumor-likeprotrusionandadistinctperinuclearpalezone,nogranules數量適中，深藍色不透明，顯示腫瘤樣突起和明顯的核周蒼白區，無顆粒Earlynormoblast（早幼紅細胞）S:10-18μm,roundorovalN:round,central

chromatinpatternslightlycondensednucleoliarepresent,butnotalwaysvisible圓形，中心染色質模式略濃縮,核仁存在，但不總是可見的C:moderateinamount,intenselyblueandopaque,perinuclearpalezoneisvisible中等量，強烈藍色和不透明，核周白色區是可見的Polychromaticnormoblast（中幼紅細胞）S:8-15μm,roundN:smaller,round,central,chromatinpatternmorecondenseindeeppurplewithdistinctvice-chromatin,givingacartwheel-shapedappearance.nucleoliabsent較小，圓形，中心，染色質模式在深紫色更濃縮，具有明顯的副染色質，呈現卡車形外觀。核仁缺失C:abundantinquantity,polychromatic數量豐富，多色Orthochromaticnormoblast（晚幼紅細胞）S:7-10μm,roundN:round,centraloreccentric,pyknoticchromatinpatterninblackpurple,vice-chromatinmayvisibleorinvisible,sometimesextrusion圓形，中心或偏心，黑色紫色的固縮染色質圖案，副染色質可見或不可見，有時擠出C:abundantinquantity,pinkerthanpreviousstage數量豐富，比上一階段更粉紅Reticulocyte（網織紅細胞）largerthanmatureredcellcontainssomeRNAremnants,polychromaticincolor包含一些RNA殘留物，多色的顏色Erythrocyte（紅細胞）6-8μmindiameter,7.2μmonaverage,

biconcavedisk,asmallareaofcentralpallor,anuclear,pink直徑6-8μm，平均7.2μm，雙凹面盤，小面積的中心蒼白，無核，粉紅色Erythroidmaturationsequence類紅細胞成熟序列stagesofmegakaryocyticmaturation:megakaryoblast（原始巨核細胞）promegakaryocyte（幼稚巨核細胞）granularmegakaryocyte（顆粒型巨核細胞）thrombocytopoieticmegakaryocyte(產血小板型巨核細胞)nakedmegakaryocyte（裸核型巨核細胞）platelet（血小板）Megakaryocyteseries

Megakaryocytopoiesisdevelopmentoccursbyendomitosis巨核細胞生成發生通過內吞Megakaryoblast（原始巨核細胞）S:15-30μm,roundorirregularN:large,roundorirregular.coarsereticularchromatininpurple,2-3vaguenucleoli大，圓形或不規則。粗網狀染色質紫色，2-3模糊核仁C:smalltomoderatecytoplasmindeepblue,mayhavepseudopod,nogranules小到中等的細胞質在深藍色，可能有pseudopod，沒有顆粒Promegakaryocyte（幼稚巨核細胞）S:30-50μm,irregularN:irregularinshape,mayshowslightlobulation,

coarserchromatin,nucleoliindistinct形狀不規則，可能顯示輕微的鱗裂，較粗的染色質，核仁不清晰C:moreamountcytoplasmindeepblue,reddish-purplegranulesvisible,pseudopodvisible更多量的細胞質在深藍色，紅紫色顆粒可見，偽足可見Granularmegakaryocyte（顆粒型巨核細胞）S:giant,

40-70μm,integritymembrane完整膜N:giant,

multiplenucleiormulti-lobulation,coarserpatchychromatinpattern巨大，多核或多葉，更粗糙的斑狀染色質模式C:veryplentifulcytoplasmfullofpurplegranules非常豐富的細胞質充滿紫色顆粒Thrombopoieticmegakaryocyte（產血小板型巨核細胞）S:40-70μm,irregular,blurredmembrane模糊膜N:giant,hyperploidnucleioftenoverliewithclumpedchromatin巨大的，超倍體核常常覆蓋有結塊的染色質C:veryplentifulcytoplasminreddish,granulesclusterandbudofftobecomeplatelet非常豐富的細胞質，紅色，顆粒簇和芽脫落成為血小板PNaked

megakaryocyte（裸核型巨核細胞）Amaturemegakaryocyticnucleuswithoutcytoplasm成熟巨核細胞核無細胞質Platelet1–4μmindiameter,givingastar-likeappearance,a