In 1884 Edwin Abbott, an English novelist, wrote a popular novel “Flatland: A Romance of Many Dimensions”. It was a reflection of great scientific imagination of a land which was of only two dimensions unlike our world of three dimensions. Naturally, the inhabitants of that “Flat land” were triangles, rectangles and circles. The book was illustrated by the author (himself a square) [1].

The world we observe in microscopic screening of blood or bone marrow films is also a flat land – a world of two dimensions. Though the creatures of this land, white cells, red cells, platelets and their precursors are originally three dimensional structures in their homeland of blood or bone marrow, they are flattened into two dimensional structures when films are made on glass slides. In this process the cytoplasmic materials overlying the nuclei slide over to the periphery to give the conventional morphological pictures of the observable cytoplasmic constituents, such as granules and vacuoles, surrounding the nucleus. Sometimes, these cytoplasmic elements still overlie the nucleus. This can be difficult to appreciate with routine hematological staining but a cytochemical stain, with a counterstain, can help to visualize them. This myeloperoxidase stain (substrate 3, 3′ DAB with a counterstain of diluted Giemsa in phosphate buffer, pH 6.8 [2]) from a patient with acute myeloid leukemia shows cytoplasmic constituents, including granules, surrounding the nucleus but several Auer rods have been left, stranded on top of the nucleus. Our flatland can be as entrancing as that described by Abbott in 1884.


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