Plasma Cell

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The page below is a sample from the LabCE course Bone Marrow Aspiration: Normal Hematopoiesis and Basic Interpretive Procedures. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Plasma Cell

Once the naive B lymphocyte leaves the bone marrow, it will enter the circulation and then travel to the lymph nodes. In the lymph nodes (or other lymph tissue) if a B lymphocyte's antigen receptor recognizes its specific antigen and attaches to it, a series of intracellular signals are sent to the nucleus to begin dividing and cloning itself, as well as starting to synthesize immunoglobulin (antibody). This process often needs the help of cytokines from T Helper Cells. Once the daughter cells of that oiginal stimulated B lymph start secreting antibodies, they are known as Plasma Cells.

Under normal circumstances, plasma cells are not a large percentage of the lymphoid cells found in a marrow. They are usually placed in a separate category in the differential, unlike viral/atypical lymphs. There can be a relative increase in plasma cells in reactive marrows, and both plasma cells and their early precursors will be markedly increased in plasma cell disorders.

While mature plasma cells somewhat resemble lymphocytes, there are a few important differences. The size of the cell is usually larger with more abundant cytoplasm. The nucleus is eccentrically placed and the overall shape of the cell generally resembles a wedge or comet with the nucleus leading the cytoplasm. The chromatin is just as thick and clumpy as a lymphocyte's but is aligned in a more "spokey" or "clockwork" pattern. The cytoplasm is usually more basophilic than the cytoplasm of a normal lymphocyte and will have a well-defined perinuclear halo or noticeable clearing in the golgi area. Vacuoles may or may not be present.

Notice the size of the single plasma cell in the top image (see red arrow). It is larger than the neutrophil precursors surrounding it and is almost rectangular in shape. Observe that the nucleus leads the cytoplasm, causing the wedge or comet shape. Sometimes, this distinct morphology is described as a "fried egg" appearance. Notice the prominent perinuclear halo.

Find the two plasma cells in the upper left corner of the second image. There is much more cytoplasm in these plasma cells compared to the occasional lymphocyte present in the field. Notice the eccentric nuclear placement as well as the characteristic clearing in the golgi area.