#Microscopic 
Blood film

#Diagnosis 👉🏻  Chronic lymohoid leukemia ( cll )


#The_black_arrows
Lymphocytes with a clumped chromatin

#The_blue_arrow
Smudge cell

#Microscopic 
Marrow film

#Diagnosis 👉🏻  Chronic lymohoid leukemia ( cll )


#The_black_arrows
Lymphocytes

#The_blue_arrow
Plasma cell

Chronic Myeloid Leukemia
Is a myeloproliferative disorder characterized by increased proliferation of the granulocytic cell line without the loss of their capacity to differentiate


#The_pathogenesis
حصل  chromosomal translocation من الكرموسوم 9 الى الكرموسوم 22 والذي يسمى ايضاً Philadelphia chromosome ( هو انتقال جينات من الكرموسوم 9 الى الكرموسوم 22 )
فكون oncogene الذي عمل activation لل tyrosine kinase فأثر على نخاع العظم فصارت الخلايا تنتج بشكل كبير جداً

وتمثل نسبة هذا النوع من السرطان 20% فقط


✓ The CML Occurs in 2 different phases
- Chronic phase or crisis
- blast phase or crisis


ونفرق بينهم من خلال الاتي
❁ Chronic phase (CP)
• Leukocytosis (usually 12 - 1,000 x 10⁹/L, median: ~ 80 x 10⁹/L)
• < 2% blasts in blood
• < 5% blasts in bone marrow


❁ Blast phase (BP)
• ≥ 20% blasts in marrow or blood or the presence of an extramedullary proliferation of blasts

اي ان الخلايا immature تكون اكثر من mature بعكس في المرحلة المزمنة تكون immature cell قليلة جداً

#Microscopic 

#Diagnosis 👉🏻  Chronic myeloid ( myelogenous ) leukemia
In the chronic phase

#The_green_arrows
Segmented neutrophils

#The_brown_arrow
Band neutrophils

#The_blue_arrow
Bisophillic

#The_black_arrow
Myelocytes

#The_red_arrow
Promyelocyte

#The_orange_arrow
Myeloblast

#Microscopic 

#Diagnosis 👉🏻  Chronic myeloid leukemia
In the blast phase

#The_black_arrow
Basophil

#The_red_arrows
Promyelocytes

#The_blue_arrow
Band neutrophils

#The_green_arrow
Myeloblast

#Microscopic 

#Diagnosis 👉🏻  Chronic eosinophilic leukemia


#The_black_arrow
Eosinophil
والتي تكون حقها الحبيبات حمراء اللون

#The_red_arrow
Myelocytes

#The_blue_arrow
Binucleate eosinophil

#The_green_arrows
Normoblast
والتي تكون قبل ما تتحول الى erythrocyte

#Microscopic 

#Diagnosis 👉🏻  plasma cell of multiple myeloma


#The_black_arrows
Plasma cells

#The_white_area
Pale zone

#The_features
- blue cytoplasm
- eccentric nucleus
- perinuclear pale zone or halo

#Microscopic 

#Diagnosis 👉🏻  myeloma

#The_white_arrow
Plasma cell

#The_black_arrows
Rouleaux
والتي تطلع ال ESR مرتفع جداً عند المريض

#Microscopic 

#Diagnosis 👉🏻  myeloma
In the state neoplastic plasma cell

#The_green_arrows
Neoplastic Plasma cell ( mononucleate )

#The_black_arrows
Neoplastic Plasma cell ( binucleate )

#The_white_area
Vacuoles

#The_features
- Neoplastic plasma cell ( large size ) occasionally binucleate or mononucleate
- Small Vacuoles in the nucleus and cytoplasm
- blue cytoplasm

The second lab DONE  ✓