HEME RBC and PLT Morphologies

Anisocytosis

Difference in size between RBCs (RDW indices) and associated with B12/folate deficiency

Hypochromia

Central pallor greater than 1/3 of the cell and a decrease in hemoglobin (irregular hemoglobin synthesis due to iron deficiency)

Hyperchromia

Loss of central pallor (hemolytic anemia from burns or toxicities)

Polychromasia

Immature RBCs that have RNA (hemorrhage and condition where bone marrow is stimulated)

Poikilocytosis

Variation in RBCs shape

Acanthocytes

(Cholesterol-phospholipid ratio increase) Liver disease, post-splenectomy, and alcohol intoxication

Burr cells

(Alteration in membrane lipid content) Heart disease and stomach cancer

Schistocytes

(Trauma to cell membrane) Prosthetic heart valve and clostridial infection

Spherocytes

(No central pallor) Post transfusion and hemolytic anemia

Target cells

(Increase in surface membrane and decrease in hemoglobin) Post splenectomy and liver disease

Teardrop cells

(Formed from passing through crowded marrow environment) Myelofibrosis

Rouleaux

(RBCs stack together) Increased plasma protein

Howell-jolly body

(Remnants of DNA) Spleen is non functional

Basophilic stippling

(Remnants of ribosomal RNA) Lead poisoning and alcoholism

Pappenheimer bodies

(Excess iron)

Heinz bodies

(Denatured hemoglobin)