W.B. C Diseases(Microbiology Pictures)

W.B. C Diseases(Microbiology Pictures)



L1 Subtype Leukemia

FAB L1 (85%)
The blasts of the L1 subtype are small, often no larger than normal small peripheral blood lymphocytes. The nuclei are usually round, but may be slightly oval and indented. Nucleoli frequently are not visible. The cytoplasm is scant and grey to light blue in color. Cytoplasmic granules are usually absent, but may be seen in some cases, especially in those that are Philadelphia chromosome positive. The cell surface may be smooth or show fine membrane projections.



L2 Subtype Leukemia

In the L2 subtype of ALL the cell size is more variable, but is usually larger by 1 1/2 to 2 times than that of the L1 subtype. The cytoplasm is more abundant and grey to blue in color. Cytoplasmic vacuoles and granules usually are not present. The nuclear contour is more variable with more indentations, and the nuclear chromatin is more clumped and one or more prominent nucleoli are usually visible. Nuclei may be cleft. From a morphologic standpoint alone L2 ALL, and M0 and M1 AMLs cannot be distinguished unless Auer rods are seen (M1).



L3 Subtype Leukemia

The morphologic appearance of the malignant cells in L3 ALL/lymphoma (Burkitt's leukemia/lymphoma) on a Wright-Giemsa stain is essentially diagnostic, especially in the classic subtype. The cells are of medium size, about 1 1/2 to 2 times larger than L1 ALL cells, and they are rather uniform in size. The cytoplasm is very basophilic (blue) and contains a variable number of lipid-laden vacuoles that stain positive with oil red 0 (neutral fat). The vacuoles frequently cluster in a Golgi distribution. The nucleus is round to slightly oval, and the nuclear chromatin is coarse but evenly dispersed with some clumping. Nucleoli are prominant and usually multiple in number. On fixed paraffin sections of bone marrow and lymph node specimens the pattern of infiltration is diffuse with a "starry sky" appearance due to histiocytic engulfment of apoptotic Burkitt tumor cells. Mitotic figures are frequent reflecting the very high proliferative rate. Resting cells are essentially non-existent



Reed Sternberg Cells
Malignant cells
B-cell





Reed Sternberg Cells
Malignant cells
B-cell

Lacunar Cells or Popcorn

Hodgkin lymphoma, nodular lymphocyte predominant type. L&H (popcorn) cells are large cells with folded nuclei resembling a popped kernel of corn (arrow), usually CD20 positive and surrounded by small T lymphocytes th

Acute Myeloblastic Leukemia With Differentiation

(M2 AML)

(a) M2 AML- Bone marrow aspirate smear, Wright-Giemsa stain, 1000x

Acute Myeloblastic Leukemia With Differentiation

(M2 AML)

(b) M2 AML with eosinophilia (M2Eo)- Bone marrow aspirate smear, Wright-Giemsa stain, 1000x

Acute Myeloblastic Leukemia With Differentiation

(M2 AML)

(c) M2 AML with some acute basophilic leukemia features- Bone marrow aspirate smear, Wright-Giemsa stain, 1000x