The contribution of scanning electron microscopy in haematology: its role in defining leucocyte and erythrocyte disorders.

This report reviews the contribution of scanning electron microscopy (SEM) in haematology. Important observations regarding red cell shape and deformities are referred to and contributions in the definition and classification erythrocyte disorders are stressed. In this field there is no doubt that SEM has contributed much to the three-dimensional visualization of RBC disorders. As far as leucocyte pathology is concerned the situation is less clear. SEM has contributed much to current knowledge and understanding of the surface properties of white blood cells. Normal leucocytes have different surface features and can be distinguished under the SEM. However, some overlap does occur, making individual distinction on the basis of surface architecture alone extremely difficult. The difficulties in this regard are discussed in this review and factors influencing the variability of surface microprojections are reviewed briefly. Leukaemic cells of different origins may also be distinguished under the SEM. However, while "hairy' cells have typical surface features and non-lymphoid leukaemic cells, in particular monocytes, are readily distinguished from lymphoid leukaemic cells, there is much overlap of surface topography. Undifferentiated cells and early myeloblasts and lymphoblasts have similar surface features and cannot be distinguished under the SEM. While SEM adds a valuable third dimension to morphology and ultrastructure, it cannot be used alone in the definition of difficult cases of acute leukaemia.