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    acute myelocytic leukemia - M1
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    • leukocyte alkaline phosphatase (LAP) stain
    • LAP stains for alkaline phosphatase enzyme activity in the cytoplasm of neutrophils. It is colored dark green/black in the preparation above. The stain is used to help differentiate between a leukemoid reaction and chronic myelocytic (granulocytic) leukemia.
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    Medium to large lymphocytes contain more cytoplasm than the small lymphcytes and can range in size from 10-14 microns. Their cytoplasm can be blue to gray and contain a few azurophilic granules
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    acute myelocytic leukemia - M5A
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    • Alder's anomaly
    • Leukocytes in Alder's anomaly have dark-staining, purplish-red granules that contain precipitated mucopolysaccharides. These granules are sometimes confused with toxic granules, which are not as large and usually stain a darker blue. Alder-Reilly inclusions are seen in Hurler's disease.
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    A prolymphocyte (#1) is seen in this film with many mature lymphocytes (#2). Prolymphocytes are the stage of lymphocyte development following the lymphoblast stage. The nucleus of the prolymphocyte is younger in appearance than the nuclei of the mature lymphocytes. A large nucleolus is also seen in the prolymphocyte.
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    • acute lymphocytic leukemia
    • ALL is characterized by lymphoblasts in the bone marrow and peripheral blood. Notice the immature chromatin, nucleoli, and high N:C ratio.
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    • hyposegmentation (Pelger-Huet)
    • The heterozygous form of congenital Pelger-Huet has mature neutrophils (similar to the one in the picture above) that have a bi-lobed nucleus separated by a thin strand of nuclear material instead of the normal 3-5 lobed nucleus. The shape of the nucleus is often described as "dumbbell" or "pince-nez" (bifocal).
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    • hairy cell
    • The nucleated "hairy cells" are found in hairy cell leukemia. Notice the streaming cytoplasmic processes.
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    • toxic granulation
    • The neutrophil above contains numerous dark purple, cytoplasmic granules that are often seen in toxic situations such as bacterial infections.
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