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Normoblast Information and Courses from MediaLab, Inc.

These are the MediaLab courses that cover Normoblast and links to relevant pages within the course.

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Red Cell Disorders: Peripheral Blood Clues to Nonneoplastic Conditions
The nucleated red blood cell and myelocyte photographed here were found on scanning of a peripheral blood smear. In context they are suggestive of metastatic carcinoma to the bone marrow.View Page
Pappenheimer bodies

Pappenheimer bodies are iron-containing granules that aggregate with mitochondria and are deposited in RBC or normoblast cytoplasm. Small and irregular, they are found only in pathological states as thalassemia and sideroblastic anemias(upper image). Wright-Giemsa stain defines the cytoplasmic content (protein), but Prussian blue staining is necessary to define the iron content, the essence of the Pappenheimer body (lower image). Pappenheimer bodies lie typically in small clusters (upper image) and tend to locate at the periphery of the red cell cytoplasm. A cluster is typically smaller than a single Howell-Jolly body.

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Leukoerythroblastosis

Illustrated in this field is a normoblast and a myelocyte, representing leukoerythroblastosis, a term associated with the release of immature cells from a disrupted marrow. Metastatic disease in the bone marrow, particularly in patients with primary breast or prostate cancer, is usually the culprit. Leukoerythroblastosis in the absence of anemia or thrombocytopenia is a signal to search for cancer metastic to the marrow. Nucleated RBCs were not identified on the blood smear seen here but were detected by an automated analyzer.The mortality rate of elderly patients with increased NRBCs, especially following accidents or general surgery, is greater.

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Normoblasts

Many of the distorted erythrocytes displayed on the previous page are also present on this one. We see anisocytosis, poikilocytosis, fragmented forms, target cells, and a few Howell-Jolly bodies. Note also circulating nucleated red blood cells (normoblasts). The presence of these normoblasts may represent a premature release from a hyperplastic marrow or, more likely, are due to a lessening of the normal inhibition of erythroid release from the marrow as a result of splenectomy, permitting their earlier entry into the circulation.

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White Cell and Platelet Disorders: Peripheral Blood Clues to Nonneoplastic Conditions
A peripheral blood smear illustrated by this photograph is highly suggestive of metastatic carcinoma.View Page
Normal Bone Marrow Cells

A normal bone marrow smear stained with Wright/Giemsa stain is captured in this photograph.Note the normal maturation sequence beginning with myelocytes (the two large cells in the left upper corner)through metamyelocytes, band neutrophils,and multi-lobed segmented neutrophils.The small cells with darkly staining, centrally placed nuclei are normoblasts (three are clustered in the left lower field).Absent in this field are eosinophils, basophils and megakaryocytes.A normal M:E ratio of 2.4:1 is calculated from the twelve myeloid cells and five normoblasts. Two lymphocytes are identified, one left center, the other left upper.

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The upper photograph of a bone marrow section reveals distinct hyperplasia with total replacement of marrow fat. A bone marrow smear stained with Wright/Giemsa is displayed in the lower photograph. Calculate the M:E ratio between myeloid and erythroid cells found in the lower photograph. The total peripheral blood white blood cell count was 5,400/cumm. This bone marrow architecture may be found in each of the following conditions except:View Page
The neutrophils illustrated in this photograph are representative of those seen in the smear. The total WBC was 28,500 cells/cumm. The appropriate report to be issued following a morphology consultation would be:View Page


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