Complete Blood Cell & Tissue Macrophage Atlas

Definitive Hematopoietic Hierarchy โ€” Multipotent stem cell commitment, megakaryocyte-biased emergency hematopoiesis, and dual-origin tissue macrophage ontogeny.

Foundations of Hematopoiesis

Hematopoiesis is the continuous physiological process by which the body produces mature cellular blood elements from self-renewing, multipotent Hematopoietic Stem Cells (HSCs) residing in specialized bone marrow niches. Through asymmetric cell division, an HSC generates both a replica to sustain the stem cell pool and a committed progenitor. Differentiation bifurcates into two classical primary branches: the Common Myeloid Progenitor (CMP) lineage (producing erythrocytes, megakaryocytes/platelets, granulocytes, and monocytes) and the Common Lymphoid Progenitor (CLP) lineage (producing B cells, T cells, and NK cells).

Bone Marrow โ†’ Bloodstream โ†’ Tissues (adult, definitive hematopoiesis)migrate to tissueHematopoieticStem Cell (HSC)MPPMultipotent Prog.Common MyeloidProgenitor (CMP)MEPMega-Erythroid๐Ÿฉธ PlateletsClotting๐Ÿ”ด RBCsO2 transportGMPGranulo-Monocyte๐Ÿ›ก๏ธ NeutrophilBacteria๐Ÿฆ  EosinophilParasites๐Ÿงน Monocytecirculates๐Ÿซง MacrophagePhagocytosisCDP(DC Progenitor)cDC1Cross-presentationcDC2T-helper primingpDCInterferonBaso/Mast Prog.(BMCP)๐Ÿ’œ BasophilHeparin๐ŸŸ  Mast CellHistamineCommon LymphoidProgenitor (CLP)B-Cell Progenitor(-> Plasma Cell)๐ŸŽฏ B CellAntibodiesโšก Plasma CellAb factoryT-Cell / NK Prog.(-> Thymus for T)๐Ÿ”ช NK CellInnate killing๐Ÿ›ก๏ธ T CellCell killingโš”๏ธ NKT CellHybrid T/NK

โ† scroll horizontally to see the full tree โ†’

Color Legend

Stem/Progenitor โ†’ any acute leukemia
Erythroid โ†’ MDS, polycythemia vera
Megakaryocyte โ†’ Essential thrombocythemia
Baso/Mast Progenitor (BMCP) โ†’ shared origin
Myeloid โ†’ AML, CML, MDS
Histiocyte / DC family โ†’ LCH, ECD, BPDCN
Mast Cell โ†’ Systemic mastocytosis
Basophil โ†’ CML marker; rare basophilic leukemia
Lymphoid โ†’ ALL, CLL, Lymphoma, Myeloma
NK Cell โ†’ Aggressive NK-cell leukemia, ENKTCL
NKT Cell โ†’ Hepatosplenic T/NK lymphoma

๐Ÿงฌ Tissue-Resident Macrophage & Dendritic Cell Origins

The tree above shows adult, bone-marrow (definitive) hematopoiesis. But many tissue-resident macrophages are not continuously replenished from bone-marrow monocytes โ€” they're seeded during development (yolk sac โ†’ fetal liver) and then self-renew locally for years to decades.

Microglia

CNS parenchyma
Embryonic 100%0% Adult BM

Seeded from primitive yolk-sac macrophages before the blood-brain barrier closes (~E8.5-9.5 in mouse). Lifelong local self-renewal; excluded from circulating monocyte input by the intact BBB.

Markers
TMEM119+, P2RY12+, CX3CR1+, IBA1+, TREM2+
Notes / Disease
TREM2 variants raise Alzheimer's disease risk. Not the origin of primary CNS lymphoma (that's B-cell derived).

CNS border-associated macrophages (BAMs)

Meninges / perivascular / choroid plexus
Embryonic 80%20% Adult BM

Distinct from parenchymal microglia โ€” sit at CNS borders. Predominantly embryonic-derived and self-renewing, though choroid plexus macrophages show more ongoing monocyte turnover than the meningeal/perivascular subsets.

Markers
CD206+, LYVE1+, MRC1+, lower TMEM119/P2RY12 than microglia
Notes / Disease
Increasingly studied in neuroinflammation and as an entry point for CNS immune surveillance.

Kupffer cells

Liver
Embryonic 85%15% Adult BM

Seeded via the EMP/fetal-liver wave prenatally. Self-renewing in steady state; monocytes are recruited and can differentiate into Kupffer-like cells mainly after significant liver injury or depletion.

Markers
CLEC4F+, VSIG4+, CD68+, CD163+ (mouse: F4/80+)
Notes / Disease
Central to hemophagocytic lymphohistiocytosis (HLH); niche for liver-metastatic tumor cells.

Alveolar macrophages

Lung
Embryonic 90%10% Adult BM

Established from fetal-liver monocytes around birth, then self-renew locally. GM-CSF (via PPAR-gamma) is essential for postnatal maturation and maintenance.

Markers
CD206+, CD169+, low CD11b (mouse: Siglec-F+)
Notes / Disease
Pulmonary alveolar proteinosis (autoimmune anti-GM-CSF antibodies impair function); adult pulmonary Langerhans cell histiocytosis (smoking-related) affects the same compartment.

Langerhans cells

Epidermis (skin)
Embryonic 80%20% Adult BM

Despite the name and dendritic morphology, these are ontogenetically macrophage-like: an early yolk-sac wave is largely replaced by fetal-liver monocyte-derived cells shortly after birth, which then self-renew locally in adult skin. Minimal bone-marrow input in steady state.

Markers
CD207+ (Langerin), CD1a+, EpCAM+, Birbeck granules (EM)
Notes / Disease
Langerhans cell histiocytosis (LCH) โ€” BRAF V600E in ~50-60% of cases.

Splenic red pulp macrophages

Spleen
Embryonic 80%20% Adult BM

EMP/fetal-liver derived, locally self-renewing; recycle senescent red blood cells and recover iron.

Markers
VCAM1+, CD68+ (mouse: F4/80+, VCAM1+)
Notes / Disease
Hairy cell leukemia classically infiltrates the red pulp.

Large peritoneal macrophages

Peritoneal cavity
Embryonic 70%30% Adult BM

Embryonic-derived, self-renewing, GATA6-dependent transcriptional program. Population share declines with age/inflammation as monocyte-derived cells take over.

Markers
GATA6+, CD11b+, F4/80(hi) (mouse), ICAM2+
Notes / Disease
A go-to model system for studying resident-vs-recruited macrophage dynamics.

Small peritoneal macrophages

Peritoneal cavity
Embryonic 10%90% Adult BM

Continuously recruited from circulating monocytes, especially during inflammation โ€” the recruited counterpart to the large peritoneal macrophage pool.

Markers
CD11b(hi), MHC-II+, F4/80(lo) (mouse)
Notes / Disease
Expand rapidly during peritonitis; used as an inflammation readout in mouse models.

Cardiac macrophages

Heart
Embryonic 40%60% Adult BM

A mixed population: an embryonic-derived resident pool is present at baseline but is progressively replaced by monocyte-derived cells with age, and monocyte-derived cells dominate after myocardial infarction.

Markers
CCR2- (embryonic-derived) vs CCR2+ (monocyte-derived) โ€” the key distinguishing marker in mouse studies
Notes / Disease
The resident-vs-recruited balance shapes post-MI remodeling, fibrosis, and conduction.

Gut (intestinal) macrophages

Lamina propria
Embryonic 5%95% Adult BM

Continuously replenished from circulating monocytes (the "monocyte waterfall" model) โ€” essentially no stable embryonic-derived population persists into adulthood, unlike most other tissue macrophages.

Markers
CD11b+, CX3CR1(hi), CD64+
Notes / Disease
Central to inflammatory bowel disease pathophysiology; short-lived, high turnover.

Dermal macrophages

Dermis (skin)
Embryonic 35%65% Adult BM

Distinct from epidermal Langerhans cells โ€” a mixed-origin population with substantial and age-increasing monocyte contribution.

Markers
CD11b+, CD64+, MHC-II+
Notes / Disease
Involved in wound healing; sometimes conflated with Langerhans cells in older literature.

Kidney macrophages

Kidney
Embryonic 50%50% Adult BM

Form a self-renewing, gap-junction-connected (connexin-43) surveillance network, but with meaningful and heterogeneous ongoing monocyte contribution depending on the nephron segment studied.

Markers
CD68+, CX3CR1+, F4/80+ (mouse)
Notes / Disease
Emerging interest in acute kidney injury and transplant rejection biology.

Adipose tissue macrophages

Fat
Embryonic 20%80% Adult BM

A modest resident population exists in lean adipose tissue, but the pool expands dramatically from monocyte recruitment in obesity ("metaflammation"), driving insulin resistance.

Markers
CD11c+ (in obesity, "crown-like structures"), CD206+ (lean, M2-like)
Notes / Disease
A major research focus in obesity/metabolic disease.

Osteoclasts

Bone
Embryonic 50%50% Adult BM

Multinucleated cells formed by fusion of monocyte/macrophage-lineage precursors. Both embryonic (EMP-derived) precursors seeding developing bone AND adult bone-marrow monocyte-lineage precursors contribute throughout life โ€” a genuinely dual-source population, unlike most entries on this list.

Markers
TRAP+ (tartrate-resistant acid phosphatase), Cathepsin K+, Calcitonin receptor+, integrin alpha-v/beta-3 (CD51/CD61)
Notes / Disease
Requires M-CSF + RANKL for fusion/activation. Osteopetrosis (loss-of-function, e.g. TCIRG1/CLCN7); Paget's disease of bone (SQSTM1/p62, overactivity); multiple myeloma bone disease (RANKL-driven osteoclast activation causing lytic lesions).

๐ŸŽ—๏ธ Sarcomas & Lineage Exceptions

Entities that don't fit cleanly into the branching tree โ€” either because they're the frankly malignant counterpart of a cell already shown, because they break the tidy one-lineage-per-cell premise, or because the name is a trap and the cell isn't even hematopoietic.

Myeloid Sarcoma (Chloroma)

AML, extramedullary
Not a distinct cell of origin โ€” this is AML (myeloblasts, from the GMP branch) growing as a solid mass outside the marrow instead of circulating. Historically named "chloroma" for the green tint from myeloperoxidase. The clearest true sarcoma in the hematologic world.
Markers
Myeloperoxidase+, CD33+, CD117+, CD68+ (monocytic variants)
Genetics
Same drivers as AML โ€” NPM1, FLT3-ITD, KMT2A rearrangements, core-binding factor translocations. Can precede marrow-confirmed AML by weeks to months.
Treatment
Treated as systemic AML (induction chemotherapy) even when the marrow looks uninvolved; radiotherapy or surgery are adjunctive only.

Histiocytic Sarcoma

Malignant macrophage/histiocyte
The frankly malignant counterpart of the Macrophage entry in the Tissue-Resident Atlas above โ€” genuinely rare and aggressive, versus the more indolent ECD/RDD/JXG spectrum shown there.
Markers
CD68+, CD163+, CD11c+, lysozyme+; lacks Langerin (CD207) and CD1a, which separates it from Langerhans-lineage tumors
Genetics
Overlapping MAPK-pathway mutations (BRAF, MAP2K1) with the more indolent histiocytoses โ€” increasingly viewed as one shared mutational spectrum rather than separate diseases.
Treatment
Poor response to conventional chemotherapy; BRAF/MEK inhibitors where a driver mutation is present; clinical trial enrollment often prioritized given rarity and poor standard outcomes.

Langerhans Cell Sarcoma

Malignant Langerhans cell
The malignant counterpart of the Langerhans cell entry in the Tissue-Resident Atlas โ€” vanishingly rare, arising either de novo or by transformation from existing LCH.
Markers
CD207+ (Langerin), CD1a+, S100+ โ€” the same immunophenotype as benign LCH, distinguished by malignant cytology and clinical behavior rather than markers
Genetics
BRAF V600E in a subset, similar to LCH.
Treatment
Aggressive multi-agent chemotherapy (sarcoma- or lymphoma-type regimens); BRAF inhibitors where the mutation is present; prognosis is poor relative to LCH.

Interdigitating Dendritic Cell Sarcoma

Malignant cDC-lineage
Arises from the CDP/conventional-DC lineage in the tree above โ€” the malignant counterpart of mature interdigitating dendritic cells that populate lymph node T-cell zones.
Markers
S100+, CD1a-, CD68 variable; lacks the Langerin/CD207 seen in Langerhans-lineage tumors
Genetics
Poorly characterized given extreme rarity; case reports describe overlapping MAPK-pathway alterations.
Treatment
No standard regimen; typically sarcoma- or lymphoma-type combination chemotherapy plus surgery or radiotherapy for localized disease.

Hodgkin Lymphoma (Reed-Sternberg cells)

Aberrant B-cell derivative
Arises from germinal-center B cells, but Reed-Sternberg and Hodgkin cells are so reprogrammed they lose most B-cell identity โ€” sitting adjacent to the B-cell/Plasma-cell entries above but behaving like their own biological category. Over 90% of the tumor mass is actually a reactive inflammatory infiltrate the malignant cells recruit and hijack for survival signals.
Markers
CD30+, CD15+, PAX5 (weak+), CD20 typically weak/negative (unlike other B-cell lymphomas), CD45 typically negative (helps distinguish from non-Hodgkin lymphoma)
Genetics
Frequent 9p24.1 amplification (PD-L1/PD-L2) driving immune evasion; NF-kB pathway activation; EBV positivity in a subset, especially mixed-cellularity subtype. Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a distinct, CD20+ "popcorn cell" entity closer to conventional B-cell biology.
Treatment
ABVD chemotherapy backbone, or escalated BEACOPP for higher-risk advanced disease; brentuximab vedotin (anti-CD30 antibody-drug conjugate) increasingly used front-line; checkpoint inhibitors (nivolumab, pembrolizumab) are notably effective, directly exploiting the 9p24.1/PD-L1 biology.

Mixed Phenotype Acute Leukemia (MPAL)

Breaks the clean tree model
Blasts co-express strong markers from two lineages at once (usually B/myeloid, sometimes T/myeloid) โ€” a living reminder that the branching tree above is a simplification. Suggests the transforming event happened at or before a lineage-commitment decision point (e.g. around the MPP/CMP-CLP junction), leaving the leukemic clone able to express programs from both downstream paths.
Markers
Diagnosis requires strong lineage-defining markers from 2+ lineages simultaneously โ€” e.g. myeloperoxidase (myeloid) plus CD19/cytoplasmic CD79a/CD22 (B-lineage)
Genetics
BCR::ABL1 and KMT2A rearrangements are disproportionately common โ€” both are known to arise in very early progenitors still capable of multi-lineage output.
Treatment
ALL-type regimens tend to outperform AML-type regimens in outcome studies; a TKI is added if BCR::ABL1+; allogeneic stem cell transplant is often considered given generally worse prognosis than single-lineage acute leukemias.

Waldenstrom Macroglobulinemia (Lymphoplasmacytic Lymphoma)

Between B-cell and Plasma cell
Sits at the transitional stage between the B-cell and Plasma-cell entries above โ€” a clonal population of small lymphocytes, plasmacytoid lymphocytes, and plasma cells all coexisting, reflecting a block partway through terminal B-cell differentiation rather than one sharply-defined stage.
Markers
CD19+, CD20+ (unlike multiple myeloma), partial CD38/CD138 on the more plasmacytic component, surface and cytoplasmic IgM
Genetics
MYD88 L265P in ~90-95% of cases, activating NF-kB signaling; CXCR4 mutations in ~30-40%, which affect response to certain therapies.
Treatment
BTK inhibitors (ibrutinib, zanubrutinib) are particularly effective given MYD88/BTK pathway dependency; rituximab-based chemoimmunotherapy; plasmapheresis for acute hyperviscosity from the IgM paraprotein.

Follicular Dendritic Cell Sarcoma

NOT on this tree โ€” not hematopoietic
A classic name-collision trap: follicular dendritic cells are NOT hematopoietic at all. They are stromal/mesenchymal cells that form the physical scaffold of lymph node germinal centers โ€” developmentally unrelated to the HSC at the top of this entire tree, and more closely related to fibroblastic reticular cells than to any blood cell. Do not confuse with Interdigitating DC Sarcoma above, which IS hematopoietic (CDP-derived).
Markers
CD21+, CD23+, CD35+ (complement receptors), clusterin+ โ€” a completely different panel from any hematopoietic dendritic cell
Genetics
Poorly defined; some association with Castleman disease (particularly the hyaline-vascular type) preceding or co-occurring.
Treatment
Surgical resection is primary; chemotherapy or radiotherapy for advanced/unresectable disease. Behaves clinically more like a soft-tissue sarcoma than a lymphoma.