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- Normal Blood Smear, Chronic Lymphocytic Leukemia and Chronic Granulocytic Leukemia

First study the normal blood smear. Note the relative abundance of red blood cells and white blood cells. Neutrophils are the most common type of WBC in normal blood.   

Normal blood (100X2.0)                                                             Normal blood - WBCs are dark (100X2.8)
Two WBCs (blue dots) and many RBCs                                 TwoWBCs (lymphocyte at left, neutrophil at far right) 
                                                                                                        and many RBCs

Now study the smear from a patient with chronic lymphocytic leukemia. Note the relative abundance of RBCs and WBCs (observing a number of fields) and note that almost all the WBCs are lymphocytes.  

Lymphocytic leukemia (100X2.0)                                             Lymphocytic leukemia (400X2.3) 
Many WBCs (dark dots), which are lymphoctes                   Four WBCs, all of which are lymphocytes

On the slide of the chronic granulocytic leukemia, note that there are more WBCs than RBCs and that the WBCs are abnormal in size, shape and nuclei. Compare these WBCs with those in the normal blood smear.

Granulocytic leukemia (100X2.8)                                           Granulocytic leukemia (400X2.3)
WBCs (blue cells) are extremely numerous, RBCs are         WBCs (blue cells) are numerous and many are dysplastic
much less numerous than in normal blood                              (i.e., have abnormal stucture {e.g., abnormally large, large 

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Copyright 2004 - Augustine G. DiGiovanna - All rights reserved.

This material may not be reproduced or distributed in any form or by any means, or stored in any data base or retrieval system without prior written permission is obtained from Augustine G. DiGiovanna, Ph.D.,  Professor of Biology, Salisbury University, Salisbury, MD  21801.