Microscopy Solutions for Hematology

Hematology (alternate spelling “haematology”) is the science or study of blood, blood-forming organs and blood diseases. In clinical routine, hematologists diagnose and treat blood disorders and malignancies, including types of hemophilia, leukemia, lymphoma and sickle-cell anemia. Hematology is a branch of internal medicine that deals with the physiology, pathology, etiology, diagnosis, treatment, prognosis and prevention of blood-related disorders.

Blood consists of several components, including erythrocytes (red blood cells), leukocytes (white blood cells), thrombocytes (platelets) and plasma. All of the aforementioned cell types are produced in the bone marrow from multipotent precursor cells in a process called hematopoiesis. Erythrocytes, which are disc-shaped and make up about 45% of whole blood, carry oxygen from the lungs to the body’s tissues and organs while also transporting carbon dioxide back to the lungs to be exhaled. Leukocytes are the cells of the immune system that are involved in protecting the body against both infectious disease and foreign invaders. Thrombocytes are small, colorless fragments that stick together and interact with coagulation factors to stop bleeding from blood vessel injury. Together with leukocytes, they make up less than 1% of whole blood volume. The fluid part of the blood, the plasma, is composed of 92% water and contains vital proteins, mineral salts, sugars, fats, hormones and vitamins.

Hematologists (alternate spelling “haematologists”) routinely investigate peripheral blood smears on glass slides with a microscope to find any abnormalities indicating hematological diseases or to look for blood parasites, such as those found for malaria and filariasis. The blood smear is dried, fixed to the slide with methanol, and stained to distinguish the various cell types. In hematology most staining techniques are Romanowski stains such as Wright’s stain, Giemsa stain, or a combination of both to detect erythrocyte, leukocyte or thrombocyte abnormalities. Light microscopy with a magnification of up to 1.000x is employed to recognize and count the various cell types within a monolayer and document the results with a digital camera. This way, many types of anemia as well as leukemia or the developmental stages of the malaria parasite Plasmodium falciparum can be detected. In certain cases, the microscopic examination of peripheral blood smears is complemented with a bone marrow examination.