CATEGORY OF BLOOD VARIATION IN SHAPE

CATEGORY OF BLOOD VARIATION IN SHAPEPOIKILOCYTOSISPRINCESS ALEN AGUILAR

A. POIKILOCYTES SECONDARY TO DEVELOPMENTAL MACROCYTOSIS

OVAL MACROCYTES (OVALOCYTES)Inc. MCVCS= Megaloblastic Anemia most popular for this cellNo cental pallor

B. POIKILOCYTES SECONDARY TO MEMBRANE ABNORMALITIES

SPHEROCYTESDec. surface volume to ratioDefects on RBC membrane CHONsSpectrin deficiency CS= Hereditary spherocytosis, AIHA, G6PD, ABO-HDN, RC ENZYME DEF.Microcytic Hyperchromic anemia

ELLIPTOCYTES ciggar shape cellCS= 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 spiculesPresent in prolonged standing artifactsResembles to Burr CellsCS= pyruvate kinase def. , uremia, hepatic therapy, renal insufficiency, suddend change in pH

Burr cells sea urchinIrregular spicules, less pointed Also seen in Renal failure and uremia

Acanthocytes Spur cells or thorn cellsVery spiny irregular projectionsCS= Abetalipoproteinemia, cirrhosis, HUS, post splenectomy, HA, PKDLysine: Sphingomyosin def.

Stomatocytes Mouth Cellw/ slit like or mouth like central pallorCS=Rh null Disease, Renal Dse, Liver DseDue to osmotic changes

TARGET CELLS/CODOCYTES MEXICAN HAT CELLS, LEPTOCYTES, PLATYCYTES, BULLS EYE, GREEK HELMET CELLSINC. VOLUME RATIOCS= Liver Dse, Hemoglobinopathies, Thalassemia, IDA

C. POIKILOCYTES SECONDARY TO TRAUMA

SCHISTOCYTES Fragmentocytes or Egg shellsCell fragmentsCS= Microangiopathic anemia, thermal injury, renal transplantation rejection, G6PD def, heart valve replacement, HA, severe burns, mechanical destruction due to TTP or DICFragmenting/disintegrating RBC

KERATOCYTES (HELMET CELLS)Horn like projectionsRed cell caught in fibrin strandsTriangle cell, keratocytes of BessisFragileCS= Hemolytic Anemia

DACROCYTES (TEAR DROP)Round cell wth elongated tailCells are squeezed into small openingCS= Myelofibrosis, Megaloblastic Anemia, Thalassemia, Pernicous Anemia

MICROSPHEROCYTES/ PYROPOIKILOCYTESOccurs in severe burnsLow MCV2-3um

D. POIKILOCYTES SECONDARY TO ABNORMAL Hgb CONTENT

SICKLE CELL/ DREPANOCYTES/ MENISCOCYTESTHIN, ELONGATED, POINTED ENDS, APPEAR CRESCENT SHAPE RBCLACK CENTRAL PALLORHgbinopathies SS, SC, SD

Hgb CC CrystalRhomboid, tetragonal or rod shaped, crystals of dense stainingAfter splenectomyCS= Homozygous Hb SC Dse

BLISTER CELLRed cell w/ single or multiple vacuoles or markedly thinned areas at the peripheryPre-cursor of helmet cellsMicroangiopathic Hemolytic Anemia

DEGMACYTE (BITE CELL)Drug-induced anemiasG6PD Def., Thalassemia, Happened due to passing through the blood vessels of the spleen some parts of the cell remains

BASOPHILIC STIPPLINGFine= Inc. polychromatophiliaBlueberry bagel appearanceCS= Lead poisoning (Plumbism), Impaired Hgb synthesis, MARemnants of RBC RNA

HOWELL JOLLY BODIESSingle: nuclear chromatic remnants, MA, HADouble: MA, Abnormal ErythropoiesisLarge single inclusionsRelated to DNA remnants

PAPPENHEIMER BODIESSIDEROTIC GRANULESSMALL DARK BLUE PURPLEPRUSSIAN BLUE= Staining non-heme iron granulesWRIGHTS STAIN= Faint blueGranules clumped togetherCS= Sideroblastic anemia, Hgbinoathies, Thalassemia, MA, myelodysplatic syndrome

CABOT RINGSRing shape, figure of 8Double or several concentricsMicrotubules remnants or mitotic spindleRarely seen in PA, lead poisoningAbnormal erythropoiesis

HEINZ BODIESDenatured HgbResidues of oxidized HgbPresence in indicative of RBC injuryw/ alcoholismG6PD def, unstable Hgb

Hb H INCLUSIONSGOLF BALL DENTSMultiple blue green spherical inclusins stained with Brilliant Cresyl Blue (BCB)

MALARIAL INCLUSIONS

WBC anomalies

Toxic granulationDark blue-black cytoplasmic granules in neutrophilThought as primary granulesShow inc.alkaline phosphatase activityFound in: acute infections drug poisoning burns

Dohle BodiesSingle or multiple light blue or gray areas in cytoplasm of neutrophilsRER & represent failure of cytoplasm to matureFound in: infections poisoning burns following chemotherapy

Hypersegmented NeutrophilsNeutrophils with six or more lobed nucleusRepresents an abnormality in maturation of neutrophilAcquired(in megaloblastic erythropoiesis) or inherited(Undritz anomaly)Found in: pernicious anemia folic acid deficiency chronic infections

Barr BodySex chromatinRepresents the second X chromosome in females (2-3% of neutrophils in females)Small,well-defined,round projection of nuclear chromatinThese cells are not found in normal males.

Degenerated Neutrophil w/ pyknotic nucleusResult from condensing of nuclear chromatin into a solid structure mass with no patternNot counted in differential cell count

Vacuolated neutrophilDegeneration of cytoplasm begins to acquire holes or as result of active phagocytosisMay reflect increased lysosomal activityFound in: septicemia severe infection

Giant NeutrophilsCan be seen occasionally in normal peripheral blood smearLarger than normal neutrophils and genrally hyperlobulatedFound in frequency of 1 in every 20,000 neutrophils but increase in disease states

Pelger-Huet Anomaly

Indicates failure of neutrophil to segment properlyBi-lobed nucleus; chromatin is coarsely clumpedMay be inherited or acquired (as in leukemias)Heterozygous for this char.shows numerous bi-lobed (dumbell shape); homozygous-round neutrophil

Chediak-Higashi Syndrome(Autosomal recessive disorder)Rare,fatal disprder found in childrenInherited as an autosomal recessive char.Contain very large,reddish-purple or greenish-gray staining granules in the cytoplasm of granulocytesIn monocytes & lymphocytes, stain bluish-purpleThese granules represent abnormal lysosomesFound in: anemia neutropenia thrombocytopenia

Alder-Reilly anomalyHeavy,coarse blue-black granules of BEN & sometimes lymphocytes & monocytesInherited conditionAssociated with Hurlers syndrome & Hunters syndrome

May-Hegglin AnomalyInherited anomaly affecting neutrophils and plateletsLarger than usual Dohle-like bodiesGiant bizarre platelets is present & function may be abnormal

Auer rodsRod-like bodies representing aggregated primary granules that stain reddish purpleFound in : cytoplasm of myeloblast, monoblast and promyelocytes in acute monocytic or acute myelogenous leukemia and eythroleukemia

Smudge or Basket cellDisintegrating nucleus of ruptured WBC

PLATELETS SATELLITOSISPlatelets encircling the peripheral borders of neutrophilsThis phenomenon is thought to be due to a serum factor which reacts in the presence of EDTA.