Page 45 - Haematologica Atlas of Hematologic Cytology

CHAPTER 5 - Parasitic and fungal diseases
ABC
DEF
GHI
Figure 1 Plasmodium falciparum in in in in a a a a a a a a a a a a a a a a a a thin blood blood cell cell smear (A) Many red blood blood cells (RBCs) parasi zed by P P fal- ciparum ciparum rings They have a a a a a a a a a a a a a a a a a a a a a a a a a delicate light-blue cytoplasm a a a a a a a a a a a a a a a a a a a a a a a a a sharply de de ned ring ring shape with one or or two chroma n n n n n n n n n n n n n n n n n dots Mul ple infec infec on on on on of of a a a a a a a a a a a a a a a a a a a a a a single red blood cell cell is more common than in in in in in in in other malaria infec infec ons Rings may locate peripherally with with some some sort of of adherence to the the the the the cell cell cell membrane the the the the the so-called “appliqués” or or or or or or “accolé” forms forms forms Note Note the the the the the “appliqué” “appliqué” forms forms forms and and some some typical “headphone” forms forms forms (B) RBCs RBCs containing containing P P falciparum falciparum rings rings rings Note Note Note the the the the the RBC RBC RBC cell cell with with two rings rings rings rings (top) one one of of which is is is an an an an an “appliqué” “appliqué” form form form form (C) RBCs RBCs containing containing P P falciparum falciparum rings rings rings rings Note Note the the the the clear and and and detai- led picture of of of the the the rings rings rings characteris characteris cs The RBC RBC ust above the the the center is is is is mul ply infected and and has an an an an “accol ” ” ” form form shaped like a a a a a a a a a a a a a a a a a a a a a a a a a a a characteris characteris c c c c c c c c c c c c c c c c c “headphone” (D) P P falciparum falciparum schizont with a a a a a a a a a a a a a a a a a a a a a a a a a a a high number number of of of of merozoites surrounding a a a a a a a a a a a a a a a a a a a a a a a a a a a large coarse clump of of of of dark-brown pigment Schizonts are are very rare in in in in P P falciparum falciparum malaria They show a a a a a a a a a a a a a a a a a a a a a a a a number number of of of of merozoites merozoites merozoites ranging from eight up to twenty-four Note Note the the the the classic rose e e e e e e e e e e e e e e e e e e e e e e e e e e e e pa pa pa pa ern of of of of merozoites merozoites merozoites Note Note also the the the the ring form inside the the the the the the RBC on on on on the the the the the the right (E) Mature P P P falciparum falciparum schizont schizont with a a a a a a a a a a a a a a a a a a high number of of of merozoites merozoites merozoites (F) A P P P falcipa- rum rum rum ruptured schizont schizont on on on on on on on the the the the the edge of of the the the the the blood smear (G) P P P falciparum falciparum macrogametocyte (female) Gametocytes are are are usually only seen in in in in long-las ng ng ng infec ons They are are are crescent- or banana-shaped and and are are are approximately 1 5 mes the the the the diameter of a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a red blood cell in in in in in in length The The The cytoplasm is is as as as a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a rule a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a dark deep blue in in in in in in the the the the macrogametocytes macrogametocytes and and and paler in in in in the the the the the the microgametocytes The The The chroma n n n n n n n n n n n n n n n and and pigment are coarser in in in in the the the the the the macrogametocytes macrogametocytes However it is is not always possible to to to to to to iden fy the the the the the gender of of a a a a a a a a a a a a a a a a a a a a a a a a a gametocyte gametocyte gametocyte gametocyte gametocyte The The remnants of of the the the the the host cell may some mes be seen the the the the the so-called “Laveran’s bib” (shown here) (H) P P falciparum falciparum microgametocyte (male) (I) P P falciparum falciparum macrogametocyte (female) 32