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Wintrobe’s
Atlas of Clinical
Hematology
SECOND EDITION
EDITORS
Babette B. Weksler, MD
Professor Emerita of Medicine
Weill Cornell Medical College
Division of Hematology-Oncology
Weill Cornell Medicine
New York, New York
Geraldine P. Schechter, MD, MACP
Professor Emerita of Medicine
George Washington University
Former Chief, Hematology Section
Veterans Affairs Medical Center
Washington, District of Columbia
Scott A. Ely, MD, MPH
Associate Director
Division of Hematopathology
Department of Pathology
Weill Cornell Medicine
New York, New York
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Acquisitions Editor: Ryan Shaw
Senior Developmental Editor: Kristina Oberle
Developmental Editor: Grace Caputo
Marketing Manager: Rachel Mante Leung
Production Project Manager: David Saltzberg
Design Coordinator: Stephen Druding
Manufacturing Coordinator: Beth Welsh
Prepress Vendor: S4Carlisle Publishing Services
2nd edition
Copyright © 2018, 2007 Wolters Kluwer
All rights reserved. This book is protected by copyright. No part of this book may be
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Printed in China
Library of Congress Cataloging-in-Publication Data
Names: Weksler, Babette B., editor. | Schechter, G. P. (Geraldine P.), editor. | Ely, Scott
(Scott Adams), editor.
Title: Wintrobe’s atlas of clinical hematology / editors, Babette B. Weksler, Geraldine
Schechter, Scott Ely.
Other titles: Atlas of clinical hematology
Description: Second edition. | Philadelphia: Wolters Kluwer Health, [2017] | Includes
bibliographical references and index.
Identifiers: LCCN 2017016339 | ISBN 9781496396594
Subjects: | MESH: Hematologic Diseases—diagnosis | Hematologic
Diseases—pathology | Atlases
Classification: LCC RB145 | NLM WH 17 | DDC 616.1/5—dc23 LC record available at
https://lccn.loc.gov/2017016339
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Contents
Contributing Authors
Preface
Acknowledgments
CHAPTER 1
Approach to the Microscopic Evaluation of Blood and
Bone Marrow
Kseniya Petrova-Drus, MD, PhD and Babette B. Weksler, MD
CHAPTER 2
Techniques for Assessing Blood Disorders: Flow
Cytometry, Multiplex Immunohistochemistry,
Karyotyping, FISH, and Molecular Approaches
Scott A. Ely, MD, MPH
CHAPTER 3
Anemia
Joshua A. Hayden, PhD and Babette B. Weksler, MD
CHAPTER 4
Hemostasis and Platelet Disorders
Marcia Paddock, MD, PhD, John V. Mitsios, PhD, and Maria T. DeSancho, MD, MSc
CHAPTER 5
Benign Diseases of Leukocytes, Spleen, and
Immunoglobulins
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Linlin Wang, MD, PhD and Sonam Prakash, MBBS
CHAPTER 6
Acute Leukemias
Julia T. Geyer, MD and Sangmin Lee, MD
CHAPTER 7
Myelodysplastic Syndromes
Olga Pozdnyakova, MD, PhD and Robert P. Hasserjian, MD
CHAPTER 8
Myeloproliferative Neoplasms
Olga Pozdnyakova, MD, PhD and Attilio Orazi, MD
CHAPTER 9
Lymphoproliferative Disorders
Elizabeth Margolskee, MD, MPH and Peter Martin, MD
CHAPTER 10
Plasma Cell Disorders
Tomer M. Mark, MD and Geraldine P. Schechter, MD, MACP
Index
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Contributing Authors
Maria T. DeSancho, MD, MSc
Associate Professor of Clinical Medicine
Division of Hematology-Medical Oncology
Weill Cornell Medicine
New York, New York
Scott A. Ely, MD, MPH
Associate Director
Division of Hematopathology
Department of Pathology
Weill Cornell Medicine
New York, New York
Julia T. Geyer, MD
Assistant Professor
Department of Pathology & Laboratory Medicine
Weill Cornell Medicine
New York, New York
Robert P. Hasserjian, MD
Director, Hematopathology Fellowship
Associate Director for Recruitment, Pathology Residency
Department of Pathology
Massachusetts General Hospital
Boston, Massachusetts
Joshua A. Hayden, PhD
Assistant Professor of Pathology and Laboratory Medicine
Weill Cornell Medicine
New York, New York
Sangmin Lee, MD
Assistant Professor of Medicine
Division of Hematology
Weill Cornell Medicine
New York, New York
Elizabeth Margolskee, MD, MPH
Fellow in Hematopathology, New York Presbyterian Hospital
Department of Pathology
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Weill Cornell Medicine
New York, New York
Tomer M. Mark, MD
Associate Professor of Medicine
Division of Hematology
University of Colorado
Aurora, Colorado
Peter Martin, MD
Associate Professor of Medicine
Division of Hematology
Weill Cornell Medicine
New York, New York
John V. Mitsios, PhD
Assistant Professor of Pathology and Laboratory Medicine
Department of Pathology
Weill Cornell Medicine
New York, New York
Attilio Orazi, MD
Professor and Chair for Hematopathology
Department of Pathology and Laboratory Medicine
Weill Cornell Medicine
New York, New York
Marcia Paddock, MD, PhD
Fellow in Hematology-Oncology
Department of Medicine
Weill Cornell Medicine
New York, New York
Kseniya Petrova-Drus, MD, PhD
Fellow in Hematopathology
Department of Pathology
Weill Cornell Medicine
New York, New York
Olga Pozdnyakova, MD, PhD
Assistant Professor, Harvard Medical School
Medical Director, Harbor Physician Diagnostics Laboratories
Associate Pathologist, Hematopathology Division
Associate Medical Director, Hematology Laboratory
Department of Pathology
Brigham & Women’s Hospital
Boston, Massachusetts
Sonam Prakash, MBBS
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Associate Clinical Professor
Department of Pathology and Laboratory Medicine
University of California at San Francisco
San Francisco, California
Geraldine P. Schechter, MD, MACP
Professor Emerita of Medicine
George Washington University
Former Chief, Hematology Section
Veterans Affairs Medical Center
Washington, District of Columbia
Linlin Wang, MD, PhD
Instructor in Pathology
Department of Pathology and Laboratory Medicine
University of California at San Francisco
San Francisco, California
Babette B. Weksler, MD
Professor Emerita of Medicine
Division of Hematology-Oncology
Weill Cornell Medicine
New York, New York
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Preface
T his second edition of Wintrobe’s Atlas of Clinical Hematology aims to update
knowledge about major aspects of blood and bone marrow disorders including new
information pertaining to their pathophysiology, diagnosis, clinical features, and pathology,
as the field has changed considerably since the publication of the first edition in 2007.
We are indebted to the original coeditors, Douglas C. Tkachuk and Jan V. Hirschman, and
their contributing authors for the wealth of images from the first edition that provided a base
from which to work. We believe that clinical and microscopic images remain an important
part of learning about and practicing hematology for both the novice and the experienced
hematologist and hematopathologist. In the decade since the publication of the first edition of
this Atlas, much has changed in our understanding of the genetics and mechanisms of blood
disorders, as well as in the development of new techniques of diagnosis, and we have
attempted to incorporate as much of this information as possible. Updated discussions of each
topic and additions of new figures expanded the chapters in the last edition. New chapters
covering hemostasis and bleeding, benign disorders of leukocytes and spleen, and plasma cell
disorders have been incorporated in this volume. We have attempted to make the
reproductions of photomicrographs and other images as clear as possible despite their very
large numbers, and to supply informative legends. In addition, recent references and
suggested readings have been appended to the chapters.
We are aware of the tremendous progress over the last decade in the rapidly expanding
power of molecular diagnostic methods. However, morphologic examination of blood, bone
marrow, and other tissues continues to provide the framework for organizing this new
knowledge and remains central to informed diagnoses, as well as to studies ranging from
classification to therapy. As before, the proposed audience includes anyone interested in
blood disorders including students, laboratory technicians, and physicians in training, as well
as oncologists, hematologists, and pathologists at every level of experience. We hope that this
Atlas will be a complement to the 13th edition and future editions of Wintrobe’s Clinical
Hematology, which feature extensive discussions and references related to the topics covered
in this volume.
While none of the editors or authors involved in this second edition of the Atlas can claim
the privilege of direct educational lineage from Maxwell Wintrobe, all have enjoyed the
benefit of his many contributions to the creation of hematology as a flourishing discipline as
well as to its practice. We also believe that the textbook he created, together with many
colleagues, has aided these endeavors for many decades and hope that this Atlas will also be
useful to both students and professionals in this important clinical and research field.
Babette B. Weksler
Geraldine P. Schechter
Scott A. Ely
10
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