Hematology all time.

Hi friends, I started writing during the initial phase of this lockdown and now we are in my 25 th post. Thanks to all my followers, subscribers, parents, siblings, teachers, family and friends for all your encouraging and lovely comments which keeps me writing.. Being the silver jubilee of my blog, I thought of making it different and special..   I would like to start with a quote by Dr.Sarvepalli Radhakrishnan whose birth anniversary is celebrated as teachers day.  "The true teachers are those who help us think for ourselves." My teachers taught me to question, to think, to reason out in  learning the subject. I feel writing about them is special and a way to show my gratitude to them. Each and everyone is unique and I have equal respect and  admiration for all my teachers, starting from my school teachers, my MBBS teachers, my MD teachers (including my senior residents and seniors), my teachers at AIIMS, Delhi and my teachers at CMC, Vellore. I can wri

Romanowsky is credited with the most important staining method used in hematology.  Was he the first person or is there anyone else before him who tried a similar staining?  Romanowsky introduced this staining in 1891. Paul Ehrlich in 1870 Even before this, in 1870, Paul Ehrlich made a significant contribution of todays blood stain. He made a neutral stain which had a mixture of acidic dye (acid fuchsin) and basic dye (methylene blue) for blood smears. To make it more interesting, I will tell you how he made this neutral stain. Ehrlich poured saturated aqueous solution of methylene blue into saturated aqueous acid fuchsin solution until the supernatant liquid was clear. Following this, he added more acid fuchsin until the precipitate redissolved. Methylene blue is said to be as one of Ehrlich favourite dyes. So what colour this neutral stain gave to blood cells? It stained the red blood cells and eosinophil granules as red, nuclei deep blue, lymphocyte cytoplasm lighte

Romanowsky staining is the most important stain used in hematology and cytology. It is a differential stain. Stains based on the principle of romanowsky principle are Leishman, Giemsa, Jenner, Wright, May- Grunwald stain and Field Stains. This staining technique is named after the Russian physician Dmitri Leonidovich Romanowsky who developed this stain in 1891. The original stain used were eosin Y and aged solutions of methylene blue.                          Dmitri Leonidovich Romanowsky (Picture taken from Google Images, Wikipedia.org) Principle: The stain consists of both cationic dye and anionic dyes. The cationic dye used is Azure B and the anionic dye is eosin Y in aqueous solutions. These two dyes act separately or in conjunction on pre-treated biological substrates to give a typical staining pattern which depends on the chemical and physical properties of the substrate. There is some concept known as Romanowsky effect. I  was not much clear o

Birbeck granules also known as Birbeck bodies are rod-shaped structures of variable length with a central, periodically striated lamella. The origin and function of these granules is still a debate.They are specific to Langerhans cells and not seen in other dendritic cells. It was first described in 1961 by Michael Stanley Clive Birbeck. Michael Birbeck   was a British scientist and electron microscopist. He worked at the Institute of Cancer Research (Chester Beatty Cancer Research Institute), London from 1950 to 1981. Birbeck granules are seen in normal langerhans granules. However, they are used to differentiate Langerhans cell histiocytoses from other proliferative disorders. The formation of these granules is induced by langerin. These structures form from the accumulation of C-type lectin Langerin (CD207)   and appears to be related to endosomal trafficking.   Langerin immunostain has replaced the need of ultrastructural analysis. Ultrastructurally, Birbeck granule

Auer rods, as the name goes, is something related to rod like structure. Yeah, they are rod- shaped crystalline structures, derived from primary granules of myeloid cells. They are characteristically seen in acute myeloid leukemias (AML). They can also be seen in myeloblasts in other conditions like myelodysplastic syndrome, myelodysplastic/myeloproliferative neoplasms. They are named after John Auer. John Auer was born in Rochester, New york in 1875 and graduated from John Hopkins Medical School in 1902. In April 1903, while John Auer was working in Dr.William Osler’ ward at John Hopkins Hospital, he saw a 21 year old man with fever, severe nose bleed, throat infection, anemia and splenomegaly. His total leucocyte count was 139x 10 9 g/dl. 92% were immature leukemic cells out of which 6-10 % leukemic cells contained rod-shaped cytoplasmic inclusions. At first, he saw the wet preparations of the patients blood and noted “refractile rod-like body”. This made him to car