A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
{184} The nature of mast-cells is undetermined. They probably
originate in the bone-marrow. They are least numerous of the
leukocytes in normal blood, rarely exceeding 0.5 per cent., or 25 to
50 per c.mm. A notable increase is limited almost exclusively to
myelogenous leukemia, where they are sometimes very numerous.
(2) Abnormal Varieties.--(_a_) Myelocytes (Plate VI).--These are large
mononuclear cells whose cytoplasm is filled with granules. Typically,
the nucleus occupies about one-half of the cell, and is round or oval.
It is sometimes indented, with its convex side in contact with the
periphery of the cell. It stains rather feebly. The average diameter
of this cell (about 15.75 µ) is greater than that of any other
leukocyte, but there is much variation in size among individual cells.
Myelocytes are named according to the character of their
granules--neutrophilic, eosinophilic, and basophilic myelocytes. These
granules are identical with the corresponding granules in the
leukocytes just described. The occurrence of two kinds of granules in
the same cell is rare.
Myelocytes are the bone-marrow cells from which the corresponding
granular leukocytes are developed. Their presence in the blood in
considerable numbers is diagnostic of myelogenous leukemia. The
neutrophilic form is the less significant. A few of these may be
present in very marked leukocytosis or any severe blood condition, as
pernicious anemia. Eosinophilic myelocytes are found only in
myelogenous leukemia, where they are often very numerous. The
basophilic variety is less common, and is confined to long-standing
severe myelogenous leukemia.
(_b_) Atypical Forms.--Leukocytes which do not fit in {185} with the
above classification are not infrequently met, especially in
high-grade leukocytosis, pernicious anemia, and leukemia. The nature
of most of them is not clear, and their number is usually so small
that they may be disregarded in making a differential count. Among
them are: (_a_) Border-line forms between polymorphonuclear
neutrophiles and neutrophilic myelocytes; (_b_) small neutrophilic
cells with a single round, deeply staining nucleus: they probably
result from division of polymorphonuclear neutrophiles; (_c_)
"irritation forms"--large non-granular mononuclear cells, whose
cytoplasm stains fairly deep purple with Wright's stain, and intense
brown with Ehrlich's: they appear in the blood under the same
conditions as myelocytes; (_d_) degenerated forms: vacuolated
leukocytes, or merely palely or deeply staining homogeneous or
reticulated masses of chromatin (Plate VI).
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