HEMATOLOGY

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Color Atlas ofHematology
PracticalMicroscopic and Clinical Diagnosis
Harald Theml, M.D.
Professor, Private Practice
Hematology/Oncology
Munich, Germany
Heinz Diem,M.D.
KlinikumGrosshadern
Institute of Clinical Chemistry
Munich, Germany
Torsten Haferlach,M.D.
Professor, KlinikumGrosshadern
Laboratory for Leukemia Diagnostics
Munich, Germany
2nd revised edition
262 color illustrations
32 tables
Thieme
Stuttgart · New York
 
 
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Library of Congress Cataloging-in-Publica-
tion Data is available from the publisher
Important note: Medicine is an ever-
changing science undergoing continual
development. Research and clinical ex-
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knowledge, in particular our knowledge of
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authors, editors, and publishers have made
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are in accordance with the state of knowl-
edge at the time of production of the
book.
Nevertheless, this does not involve, imply,
or express any guarantee or responsibility
on the part of the publishers in respect to
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quested to examine carefully the manu-
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and to check, if necessary in consultation
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This book is an authorized revised
translation of the 5th German edition
published and copyrighted 2002 by
Thieme Verlag, Stuttgart, Germany.
Title of the German edition:
Taschenatlas der Hämatologie
Translator: Ursula Peter-Czichi PhD,
Atlanta, GA, USA
1st German edition 1983
2nd German edition 1986
3rd German edition 1991
4th German edition 1998
5th German edition 2002
1st English edition 1985
1st French edition 1985
2nd French edition 2000
1st Indonesion edition 1989
1st Italian edition 1984
1st Japanese edition 1997
! 2004 Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart,
Germany
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Typesetting and printing in Germany by
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ISBN 3-13-673102-6 (GTV)
ISBN 1-58890-193-9 (TNY) 1 2 3 4 5
 
 
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Preface
Our Current Edition
Although this is the second English edition of our hematology atlas, this
edition is completely new. As an immediate sign of this change, there are
now three authors. The completely updated visual presentation uses dig-
ital images, and the content is organized according to themost up-to-date
morphological classification criteria.
In this new edition, our newly formed team of authors from Munich
(the “Munich Group”) has successfully shared their knowledge with you.
Heinz Diem and Torsten Haferlach are nationally recognized as lecturers
of the diagnostics curriculum of the German Association for Hematology
and Oncology.
Goals
Most physicians are fundamentally “visually oriented.” Apart from imme-
diate patient care, the microscopic analysis of blood plays to this prefer-
ence. This explains the delight and level of involvement on the part of
practitioners in the pursuit of morphological analyses.
Specialization notwithstanding, the hematologist wants to preserve
the opportunity to performgroundbreaking diagnostics in hematology for
the general practitioner, surgeon, pediatrician, theMTA technician, and all
medical support personnel. New colleagues must also be won to the
cause. Utmost attention to the analysis of hematological changes is es-
sential for a timely diagnosis.
Even before bone marrow cytology, cytochemistry, or immunocyto-
chemistry, information based on the analysis of blood is of immediate rel-
evance in the doctor’s office. It is central to the diagnosis of the diseases of
the blood cell systems themselves, which make their presence known
through changes in blood components.
The exhaustive quantitative and qualitative use of hematological diag-
nostics is crucial. Discussions with colleagues from all specialties and
teaching experience with advanced medical students confirm its impor-
tance. In cases where a diagnosis remains elusive, the awareness of the
next diagnostic step becomes relevant. Then, further investigation
through bonemarrow, lymphnode, or organ tissue cytology can yield firm
results. This pocket atlas offers the basic knowledge for the use of these
techniques as well.
 
 
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Organization
Reflecting our goals, the inductive organization proceeds from simple to
specialized diagnostics. By design, we subordinated the description of the
bone marrow cytology to the diagnostic blood analysis (CBC). However,
we have responded to feedback from readers of the previous editions and
have included the principles of bone marrow diagnostics and non-
ambiguous clinical bone marrow findings so that frequent and relevant
diagnoses can be quickly made, understood, or replicated.
The nosology and differential diagnosis of hematological diseases are
presented to you in a tabular form. We wanted to offer you a pocketbook
for everyday work, not a reference book. Therefore, morphological curi-
osities, or anomalies, are absent in favor of a practical approach to mor-
phology. The cellular components of organ biopsies and exudates are
briefly discussed, mostly as a reminder of the importance of these tests.
The images are consistently photographed as they normally appear in
microscopy (magnification 100 or 63 with oil immersion lens, oc-
casionally master-detail magnification objective 10 or 20). Even though
surprising perspectives sometimes result from viewing cells at a higher
magnification, the downside is that this by nomeans facilitates the recog-
nition of cells using your own microscope.
Instructions for the Use of this Atlas
The organization of this atlas supports a systematic approach to the study
of hematology (see Table of Contents). The index offers ways to answer
detailed questions and access the hematological terminology with refer-
ences to the main description and further citations.
The best way to become familiar with your pocket atlas is to first have a
cursory look through its entire content. The images are accompanied by
short legends. On the pages opposite the images youwill find correspond-
ing short descriptive texts and tables. This text portion describes cell phe-
nomena and discusses in more detail further diagnostic steps as well as