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147 cs: Chronická myeloidní leukémie - akcelerace onemocnění
en: Chronic myelogenous leukaemia - accelerated phase
7 Irena Trnavská, J. Kissová 3.5.2008, 21:08 9.9.2009, 23:06 9.9.2009, 23:06 J. Kissová


Nalezené obrázky* (n=11)

AML without maturation- BM- MPOX
There are the  most negative cells in myeloperoxidase staining. But three immature cells in the picture (at left) are cleary positive. One positive cell at right is more mature (metamyelocyte or even band) and cannot be count in numer of positive blasts.   / Většina buněk je negativní v barvení myeloperoxidázy. Ale tři nezralé buňky na obrázku (vlevo) jsou jasně pozitivní. Jedna pozitivní buňka vpravo je více zralá (metamyelocyt nebo dokonce tyčka) a nemůže být započtena do počtu pozitivních blastů. Description: There are the most negative cells in myeloperoxidase staining. But three immature cells in the picture (at left) are cleary positive. One positive cell at right is more mature (metamyelocyte or even band) and cannot be count in numer of positive blasts.
Type: bone marrow
Klíčová slova*: myeloblast, metamyelocyte, band, myeloperoxidase stain
AML with multilineage dysplasia - BM
There are three myeloblasts in the picture, one of them underneath the centre with cleft nucleus. Three immature cells of erythroid lineage (proerythroblast and two more or less mature early normoblasts) belong to cells localized around the picture's centre. At 5 o'clock lays one dysplastic cell of perhaps granulocytic or may be monocytic lineage; it has band-like but really immature nucleus with fine chromatin and clear nucleoli and immature cytoplasm without granulation. Another almost bizarre cell is in the centre, it the most probably belongs in granulocytic series, it has moderately mature nucleus, basophilic cytoplasm almost without granulation but with one digested late normoblast.  / Na obrázku jsou tři myeloblasty, jeden z nich pod centrem se štěpeným jádrem. Tři nezralé buňky erytroidní linie (proerytroblast a dva méně či více zralé časné normoblasty patří k buňkám umístěným okolo středu obrázku. Na 5. hodině leží dysplastická buňka granulocytární nebo možná monocytární řady; má tyčkovité ale opravdu nezralé jádro s jemným chromatinem a jasnými jadérky a nezralou cytoplazmu bez granulace. Jiná téměř bizarní buňka je ve středu, nejpravděpodobněji  patří ke granulocytární řadě, má středně zralé jádro, basofilní cytoplazmu téměř bez granulace ale s jedním pohlceným pozdním normoblastem. Description: There are three myeloblasts in the picture, one of them underneath the centre with cleft nucleus. Three immature cells of erythroid lineage (proerythroblast and two more or less mature early normoblasts) belong to cells localized around the picture's centre. At 5 o'clock lays one dysplastic cell of perhaps granulocytic or may be monocytic lineage; it has band-like but really immature nucleus with fine chromatin and clear nucleoli and immature cytoplasm without granulation. Another almost bizarre cell is in the centre, it the most probably belongs in granulocytic series, it has moderately mature nucleus, basophilic cytoplasm almost without granulation but with one digested late normoblast.
Type: bone marrow
Klíčová slova*: myeloblast, proerythroblast, basophilic normoblast, haemophagocytosis
AML with multilineage dysplasia - BM
There are seven myeloblasts underneath the centre of the picture and three proerythroblasts at the upper left. Between these two groups of the cells lies one agranular band and one red mitosis. Two early polychromatophil red cells precursors (upper left) have megaloblastoid nuclear pattern  and they are bilobated. Three late polychromatophil normoblasts (to the left and down from the centre) have pycnotic nuclei.   / Pod centrem obrázku je sedm myeloblastů a tři proerytroblasty jsou vlevo nahoře. Mezi těmito dvěma skupinami buněk leží jedna agranulární tyčka a jedna červená mitóza. Dva časné
polychromatofilní prekurzory erytrocytů mají megaloblastoidní vzhled jádra a jsou bilobární. Tři pozdní polychromatofilní normoblasty (doleva a dolu z centra) mají pyknotická jádra. Description: There are seven myeloblasts underneath the centre of the picture and three proerythroblasts at the upper left. Between these two groups of the cells lies one agranular band and one red mitosis. Two early polychromatophil red cells precursors (upper left) have megaloblastoid nuclear pattern and they are bilobated. Three late polychromatophil normoblasts (to the left and down from the centre) have pycnotic nuclei.
Type: bone marrow
Klíčová slova*: myeloblast, proerythroblast, polychromatophilic normoblast, megaloblastic haematopoiesis
Chronic myelogenous leukaemia - chronic phase
Although predominant populations in peripheral blood smears in the disease represent mature segmented neutrophils and myelocytes, all type of immature cells of granulocytic lineage can occur. There are two bands in the picture (2 o'clock and 7 o'clock), and there is one promyelocyte (at 8 o'clock).      / I když dominujícími populacemi u této choroby jsou v nátěru periferní krve neutrofilní segmenty a myelocyty, mohou se objevit všechny nezralé buňky granulocytární řady. Na obrázku jsou dvě tyče (na 2. a 7. hodině) a promyelocyt (na 8. hodině). Description: Although predominant populations in peripheral blood smears in the disease represent mature segmented neutrophils and myelocytes, all type of immature cells of granulocytic lineage can occur. There are two bands in the picture (2 o'clock and 7 o'clock), and there is one promyelocyte (at 8 o'clock).
Type: peripheral blood
Klíčová slova*: promyelocyte, myelocyte, band, segmented granulocyte
Megaloblastic haematopoiesis- BM
Giant metamyelocytes and bands in neutrophil series are usually present. Detection of these cells is diagnostically important in cases, when megaloblastic features of erythropoiesis are masked by co-existing iron deficiency. Granulopoiesis use to be also hyperplastic in bone marrow, although less so than erythropoiesis.   / V neutrofilní řadě jsou obvykle jsou přítomny velké metamyelocyty a tyče. Detekce těchto buněk je diagnosticky důležitá v případech, kdy jsou megaloblastické rysy erytropoézy maskovány současně přítomným nedostatkem železa. Granulopoéza je v kostní dřeni rovněž zmnožena, i když méně nežli erytropoéza.  Description: Giant metamyelocytes and bands in neutrophil series are usually present. Detection of these cells is diagnostically important in cases, when megaloblastic features of erythropoiesis are masked by co-existing iron deficiency. Granulopoiesis use to be also hyperplastic in bone marrow, although less so than erythropoiesis.
Type: bone marrow
Klíčová slova*: giant band cell, giant metamyelocyte
Plasmodium falciparum and malariae- PB
Plasmodium falciparum causes malignant tertian malaria. Erythrocytes are not enlarged, in some of them Mauer dots are present.
Plasmodium malariae causes quartan malaria. Parasites do not enlarge erythrocyte and dots are not present. Typical band form of plasmodia malarie on the right side at the bottom of the pictute is present. Typical band form of Plasmodia malarie in the centre of the pictute is present. / Plasmodium falciparum je původcem maligní třídenní malárie. Erytrocyty nejsou zvětšeny,v některých je Mauerovo tečkování.
Plasmodium malariae je původcem malárie čtyřdenní (kvartána). Parazit nezvětšuje krvinku a chybí  tečkování. V erytrocytu  v centru je typická "tyčkovitá" formace Plasmodia malariae.
Description: Plasmodium falciparum causes malignant tertian malaria. Erythrocytes are not enlarged, in some of them Mauer dots are present. Plasmodium malariae causes quartan malaria. Parasites do not enlarge erythrocyte and dots are not present. Typical band form of plasmodia malarie on the right side at the bottom of the pictute is present. Typical band form of Plasmodia malarie in the centre of the pictute is present.
Type: peripheral blood
Klíčová slova*: Plasmodium falciparum, Plasmodium malariae
Plasmodium falciparum and malariae - PB
Plasmodium falciparum causes malignant tertian malaria. Erythrocytes are not enlarged, in some of them Mauer dots are present.
Plasmodium malariae causes quartan malaria. Parasites do not enlarge erythrocyte and  dots are not present. Typical band form of Plasmodia malarie on the right side at the bottom of the picture is present. / Plasmodium falciparum je původcem maligní třídenní malárie. Erytrocyty nejsou zvětšeny,v některých je Mauerovo tečkování.
Plasmodium malariae je původcem malárie čtyřdenní (kvartána). Parazit nezvětšuje krvinku a chybí  tečkování. V erytrocytu vpravo dole typická "tyčkovitá" formace Plasmodia malariae. Description: Plasmodium falciparum causes malignant tertian malaria. Erythrocytes are not enlarged, in some of them Mauer dots are present. Plasmodium malariae causes quartan malaria. Parasites do not enlarge erythrocyte and dots are not present. Typical band form of Plasmodia malarie on the right side at the bottom of the picture is present.
Type: peripheral blood
Klíčová slova*: Plasmodium falciparum, Plasmodium malariae
CML accelerated phase - PB
Predominance of segmented granulocytes, neutrophil band in the centre, eosinophil myelocyte at the right side bottom, cluster of three blasts in the centre.
 / Převaha neutrofilních segmentů, neutrofilní tyč uprostřed, eozinofilní myelocyt vpravo dole, shluk tří blastů uprostřed. 
Description: Predominance of segmented granulocytes, neutrophil band in the centre, eosinophil myelocyte at the right side bottom, cluster of three blasts in the centre.
Type: peripheral blood
Klíčová slova*: myeloblast, eosinophil, band, segmented granulocyte
CML accelerated phase - BM
Hyperplastic bone marrow with increased number of granulopoetic cells, predominant population represent myelocytes and segmented granulocytes,  blasts and eosinophiles are increased. Blast is on the right side bottom , two eosinophil myelocytes are present - one up and one at the bottom in the centre of the picture.  
 / Hyperplastická kostní dřeň se zmnožením buněk granulopoezy, dominující populací jsou 
myelocyty a neutrofilní segmenty, zmnoženy blasty a eozinofily. Blast vlevo dole, dva eozinofilní myelocyty - jeden nahoře a jeden dole uprostřed obrázku. 
Description: Hyperplastic bone marrow with increased number of granulopoetic cells, predominant population represent myelocytes and segmented granulocytes, blasts and eosinophiles are increased. Blast is on the right side bottom , two eosinophil myelocytes are present - one up and one at the bottom in the centre of the picture.
Type: bone marrow
Klíčová slova*: myeloblast, myelocyte, metamyelocyte, eosinophil, band, segmented granulocyte
CML accelerated phase - BM
Hyperplastic bone marrow with increased number of granulopoetic cells, predominant population represent myelocytes and segmented granulocytes,  blasts and eosinophiles are increased, marked basophilia. Blasts are in the centre and on the right and left side (at 9 and 2 o'clock), eosinophil is in the centre below segmented granulocyte. Four basophiles are present - two at the right side up and two at the bottom part of the picture.

 
   / Hyperplastická kostní dřeň se zmnožením buněk granulopoezy, dominující populací jsou 
myelocyty a neutrofilní segmenty, zmnoženy blasty a eozinofily, výrazná bazofilie. Blasty uprostřed , dále vlevo i vpravo (na 9.a 2.hodině), eozinofil uprostřed pod neutrofilním segmentem,. Bazofilyjsou  přítomny 4, dva vpravo nahoře a dva ve spodní části 
obrázku. 
Description: Hyperplastic bone marrow with increased number of granulopoetic cells, predominant population represent myelocytes and segmented granulocytes, blasts and eosinophiles are increased, marked basophilia. Blasts are in the centre and on the right and left side (at 9 and 2 o'clock), eosinophil is in the centre below segmented granulocyte. Four basophiles are present - two at the right side up and two at the bottom part of the picture.
Type: bone marrow
Klíčová slova*: myeloblast, myelocyte, eosinophil, basophil, band, segmented granulocyte
MDS RAEB II
In the centre of the picture there is a dysplastic megakaryocyte with devided nucleus, maturation caryomere  is seen on  the left part of it's  cytoplasm.
Above this megakaryocyte you can see a  lymphoblast with condensed chromatin. At the right there is a hypergranular band form of neutrophil. / Ve středu obrázku je dysplastický megakaryocyt s fragmentovaným jádrem, částečně v levé části vyzrává cytoplasma v karyomer.
U horního okraje obrázku je lymfoblast (prstenčitě kondenzovaný chromatin), vpravo hypergranulovaná tyčka. Description: In the centre of the picture there is a dysplastic megakaryocyte with devided nucleus, maturation caryomere is seen on the left part of it's cytoplasm. Above this megakaryocyte you can see a lymphoblast with condensed chromatin. At the right there is a hypergranular band form of neutrophil.
Type: bone marrow
Klíčová slova*: megakaryocyte