Bone marrow - nonneoplastic
Normal
Hematogones

Author: Dragos Luca, M.D. (see Authors page)

Revised: 3 July 2017, last major update August 2012

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Bone marrow hematogones

Cite this page: Hematogones. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/bonemarrowhematogones.html. Accessed November 20th, 2017.
Definition / general
  • Hematogones are lymphoid progenitor cells, usually < 1% of bone marrow cells
  • May become hyperplastic ( > 5%), markedly hyperplastic ( > 25% - uncommon) or very numerous (70% - rare)
  • Often found in young children as normal finding and may be most common lymphoid population in neonates (Biol Neonate 2004;86:247)
Clinical features
  • Also associated with childhood cytopenias, neoplasms, viral infections, ITP (Egypt J Immunol 2005;12:9) and regenerative marrow after chemotherapy or bone marrow transplantation
  • Occasionally encountered in adults with lymphoma, myelosuppressive therapy, chronic viral infections and autoimmune diseases (Am J Clin Pathol 1994;102:202)
  • May distort analysis of acute lymphoblastic leukemia in flow cytometry since markers are similar
  • Have been separated into three types (Neoplasma 2005;52:502)
Case reports
Microscopic (histologic) description
  • Hematogones: highly condensed chromatin, inconspicuous nuclei and scant cytoplasm; except for neonates, generally not evident in peripheral blood but are identifiable in pediatric bone marrow
  • Lymphoblast: resembles lymphoblasts in ALL; 10 - 20 microns (small / medium size), round / oval with sparse, deeply basophilic cytoplasm without granules but may have vacuoles; indented nucleus with homogeneous fine, lacy and smudged chromatin; variable nucleoli; not identifiable in normal bone marrow
  • Prolymphocyte: same size as lymphoblasts (10 - 20 microns) but more cytoplasm than lymphoblasts or mature lymphocytes, usually homogeneously blue cytoplasm; central round nucleus with single prominent nucleolus; coarser chromatin than lymphoblasts; N/C ratio is 75 - 85%; not identifiable in normal bone marrow
  • Lymphocytes: 7 - 15 microns, round / ovoid but may have notches or indentations; variable light blue cytoplasm (often sparse); dense chromatin, usually no nucleolus; N/C ratio is 35 - 85%
Microscopic (histologic) images

Images hosted on PathOut server:

Child with three large hematogone
cells in upper left that have sparse,
lightly basophilic cytoplasm

5 month old with neuroblastoma
and increased hematogones
evenly distributed

Hematogones have clumped
nuclear chromatin and
no distinct nucleoli



Images hosted on other servers:

Various images

Post umbilical cord blood transplant

Hematogones - left vs. ALL - right

Flow cytometry Images

Images hosted on other servers:

Hematogones

Positive stains
Negative stains
  • Surface immunoglobulin
  • No PAS+ globules
Molecular / cytogenetics description
  • Normal karyotype
  • Normal DNA content
  • Negative clonality studies
Differential diagnosis