Category of blood variation in shape "POIKILOCYTOSIS"

CATEGORY OF BLOOD VARIATION IN SHAPE“POIKILOCYTOSIS”PRINCESS ALEN AGUILAR

A. POIKILOCYTES SECONDARY TO

DEVELOPMENTAL MACROCYTOSIS

OVAL MACROCYTES (OVALOCYTES)

• Inc. MCV

• CS= Megaloblastic Anemia most popular for this cell

• No cental pallor

B. POIKILOCYTES SECONDARY TO MEMBRANE

ABNORMALITIES

SPHEROCYTES

Dec. surface volume to ratio

Defects on RBC membrane CHONs

Spectrin deficiency

CS= Hereditary spherocytosis, AIHA, G6PD, ABO-HDN, RC ENZYME DEF.

Microcytic Hyperchromic anemia

ELLIPTOCYTES “ciggar shape cell”

CS= IDA, Pernicious Anemia, Hereditary elliptocytosis, Myelofibrosis w/ myeloid dysplasia, Megaloblastic Anemia, SCA, Thalassemia, Congenital disorder of diserythropoiesis

ECHINOCYTES (CRENATED RBC)

Short equally spaced projections, regular spicules

Present in prolonged standing artifacts

Resembles to Burr Cells

CS= pyruvate kinase def. , uremia, hepatic therapy, renal insufficiency, suddend change in pH

Burr cells “sea urchin”

Irregular spicules, less pointed

Also seen in Renal failure and uremia

Acanthocytes “Spur cells or thorn cells”

Very spiny irregular projections

CS= Abetalipoproteinemia, cirrhosis, HUS, post splenectomy, HA, PKD

Lysine: Sphingomyosin def.

Stomatocytes “Mouth Cell”

w/ slit like or mouth like central pallor

CS=Rh null Disease, Renal Dse, Liver Dse

Due to osmotic changes

TARGET CELLS/CODOCYTES

MEXICAN HAT CELLS, LEPTOCYTES, PLATYCYTES, BULL’S EYE, GREEK HELMET CELLS

INC. VOLUME RATIO

CS= Liver Dse, Hemoglobinopathies, Thalassemia, IDA

C. POIKILOCYTES SECONDARY TO TRAUMA

SCHISTOCYTES “Fragmentocytes or Egg shells”

Cell fragments

CS= Microangiopathic anemia, thermal injury, renal transplantation rejection, G6PD def, heart velve replacement, HA, severe burns, mechanical destruction due to TTP or DIC

Fragmenting/disintegrating RBC

KERATOCYTES (HELMET CELLS)

Horn like projections

Red cell caught in fibrin strands

Triangle cell, keratocytes of Bessis

FragileCS= Hemolytic

Anemia

DACROCYTES (TEAR DROP)

Round cell wth elongated tail

Cells are squeezed into small opening

CS= Myelofibrosis, Megaloblastic Anemia, Thalassemia, Pernicous Anemia

MICROSPHEROCYTES/ PYROPOIKILOCYTES

Occurs in severe burns

Low MCV

2-3um

D. POIKILOCYTES SECONDARY TO ABNORMAL Hgb CONTENT

SICKLE CELL/ DREPANOCYTES/ MENISCOCYTES

THIN, ELONGATED, POINTED ENDS,

APPEAR CRESCENT SHAPE RBC

LACK CENTRAL PALLOR

Hgbinopathies SS, SC, SD

Hgb CC Crystal

Rhomboid, tetragonal or rod shaped, crystals of dense staining

After splenectomy

CS= Homozygous Hb SC Dse

BLISTER CELL

Red cell w/ single or multiple vacuoles or markedly thinned areas at the periphery

Pre-cursor of helmet cells

Microangiopathic Hemolytic Anemia

DEGMACYTE (BITE CELL)

Drug-induced anemias

G6PD Def., Thalassemia,

Happened due to passing through the blood vessels of the spleen some parts of the cell remains

BASOPHILIC STIPPLING

Fine= Inc. polychromatophilia

Blueberry bagel appearance

CS= Lead poisoning (Plumbism), Impaired Hgb synthesis, MA

Remnants of RBC RNA

HOWELL JOLLY BODIES

Single: nuclear chromatic remnants, MA, HA

Double: MA, Abnormal Erythropoiesis

Large single inclusions

Related to DNA remnants

PAPPENHEIMER BODIES

SIDEROTIC GRANULES

SMALL DARK BLUE PURPLE

PRUSSIAN BLUE= Staining non-heme iron granules

WRIGHTS STAIN= Faint blue

Granules clumped together

CS= Sideroblastic anemia, Hgbinoathies, Thalassemia, MA, myelodysplatic syndrome

CABOT RINGS

Ring shape, figure of 8

Double or several concentrics

Microtubules remnants or mitotic spindle

Rarely seen in PA, lead poisoning

Abnormal erythropoiesis

HEINZ BODIES

Denatured Hgb

Residues of oxidized Hgb

Presence in indicative of RBC injury

w/ alcoholism

G6PD def, unstable Hgb

Hb H INCLUSIONS

“GOLF BALL DENTS”

Multiple blue green spherical inclusins stained with Brilliant Cresyl Blue (BCB)

MALARIAL INCLUSIONS