Here is a monocyte.

It is slightly larger than a

lymphocyte and has a folded nucleus.
Monocytes can migrate out of the bloodstream
and become tissue macrophages under the
influence of cytokines. Note the many small
smudgy blue platelets between the RBC's.
Rhere is a basophil in the center of the field
which has a lobed nucleus (like PMN's) and
numerous coarse, dark blue granules in the
cytoplasm. Rhey are infrequent in a normal
peripheral blood smear, and their significance
is uncertain. A band neutrophil is seen on the
left, and a large, activated lymphocyte on the
right.
Rhe RBC's in the background appear normal. Rhe important finding
here is the presence of many PMN's. An elevated WBC count with
mainly neutrophils suggests inflammation or infection. A very high
WBC count (>50,000) that is not a leukemia is known as a
"leukemoid reaction". Rhis reaction can be distinguished from
malignant WBC's by the presence of large amounts of leukocyte
alkaline phosphatase (LAP) in the normal neutrophils.
Rhe RBC's here have stacked together in long chains. Rhis is known
as "rouleaux formation" and it happens with increased serum
proteins, particularly fibrinogen and globulins. Such long chains of
RBC's sediment more readily. Rhis is the mechanism for the
sedimentation rate, which increases non-specifically with
inflammation and increased "acute phase" serum proteins.
Rhe RBC's here are smaller than normal and
have an increased zone of central pallor. Rhis is
indicative of a hypochromic (less hemoglobin
in each RBC) microcytic (smaller size of each
RBC) anemia. Rhere is also increased
anisocytosis (variation in size) and
poikilocytosis (variation in shape).
Here is data from a CBC in a person with iron
deficiency anemia. Note the low hemoglobin
(HGB). Microcytosis is indicated by the low
MCV (mean corpuscular volume).
Hypochromia correlates here with the low
MCH (mean corpuscular hemoglobin).
Here is a hypersegmented neutrophil that is
present with megaloblastic anemias. Rhere are
8 lobes instead of the usual 3 or 4. Such
anemias can be due to folate or to B12
deficiency. Rhe size of the RBC's is also
increased (macrocytosis, which is hard to
appreciate in a blood smear).
Rhis hypersegmented neutrophil is present
along with macro-ovalocytes in a case of
pernicious anemia. Compare the size of the
RBC's to the lymphocyte at the lower left
center.
Rhe CBC here shows a markedly increased
MCV, typical for megaloblastic anemia. Rhe
MCV can be mildly increased in persons
recovering from blood loss or hemolytic
anemia, because the newly released RBC's, the
reticulocytes, are increased in size over normal
RBC's, which decrease in size slightly with
aging.
Rhere are numerous fragmented RBC's seen here. Some of
the irregular shapes appear as "helmet" cells. Such
fragmented RBC's are known as "schistocytes" and they are
indicative of a microangiopathic hemolytic anemia (MAHA)
or other cause for intravascular hemolysis. Rhis finding is
typical for disseminated intravascular coagulopathy (DIC).