RBC ANOMALIES

ANISOCYTOSIS

ABNORMAL VARIATION IN RBC VOLUME OR DIAMETER

ANISOCYTOSIS

hemolytic , megaloblastic, iron deficiency anemia

oval macrocyte

Large oval RBC

oval macrocyte

SEEN IN MEGALOBLASTIC ANEMIA

MICROCYTE

small red blood cell (

MICROCYTE

iron deficiency anemia, anemia of chronic inflammation, thalassemia/hb e disease and trait

POIKILOCYTOSIS

SEVERE anemia; certain shapes helpful diagnosticaly

POIKILOCYTOSIS

Abnormal variation IN RBC shape

SPHEROCYTE

Small, round, dense RBC with no central pallor

SPHEROCYTE

SPHEROCYTE

HEREDITARY SPHEROCYTOSIS, IMMUNE HEMOLYTIC ANEMIA, EXTENSIVE BURNS (ALONG WITH SCHISTOCYTES)

ELLIPTOCYTE , OVALOCYTES

ELLIPTICAL (CIGAR SHAPED), OVAL (EGG SHAPED)

- ROUNDED ENDS

ELLIPTOCYTE , OVALOCYTES

ELLIPTOCYTE , OVALOCYTES

HEREDITARY ELLIPTOCYTOSIS OR OVALOCYTOSIS, IRON DEFICIENCY ANEMIA, THALASSEMIA MAJOR, MYELOPHTHISIC ANEMIAS

STOMATOCYTE

RBC WITH SLIT -LIKE AREA OF CENTRAL PALLOR

STOMATOCYTE

STOMATOCYTE

HERIDITARY STOMATOCYTOSIS, RH DEFICIENCY SYNDROME (RH NULL), ACQUIRED STOMATOCYTOSIS (LIVER DSE, ALCOHOLISM)

ARTIFACT

SICKLE CELL/OAT CELL

THIN, DENSE , ELONGATED RBC POINTED AT EACH END: MAY BE CURVED

SICKLE CELL/OAT CELL

SICKLE CELL/OAT CELL

SICKLE CELL ANEMIA

SICKLE CELL-B THALASSEMIA

HB C CRYSTAL

Hexagonal crystal of dense hemoglobin formed within the RBC membrane

HB C CRYSTAL

HB C DSE

HB SC CRYSTAL

Finger-like or quartz-like crystal of dense hemoglobin protruding from the RBC membrane

HB SC CRYSTAL

HB SC DSE

TARGET CELL/CODOCYTE

RBC with hemoglobin concentrated in the center and around the periphery resembling a target

TARGET CELL/CODOCYTE

BULLS EYE APPEARANCE

TARGET CELL/CODOCYTE

LIVER DSE

HEMOGLOBINOPATHIES

THALASSEMIA

SCHISTOCYTE/SCHIZOCYTE

Fragmented RBC due to rupture in the peripheral circulation

SCHISTOCYTE/SCHIZOCYTE

MICROANGIOPATHIC HEMOLYTIC ANEMIA (ALONG WITH MICROSPHEROCYTES), MACROANGIOPATHIC HEMOLYTIC ANEMIA, EXTENSIVE BURNS (ALONG WITH MICROSPHEROCYTES)

HELMET CELL(KERATOCYTE)

RBC FRAGMENT IN SHAPE OF HELMENT

FOLDED CELL

RBC WITH MEMBRANE FOLDED COVER

FOLDED CELL

Hb C disease

Hb SC disease

Acanthocyte (spur cell)

Small, dense RBC with few irregularly spaced projections of varying length

Acanthocyte (spur cell)

SEVERE Liver disease(SPUR CELL ANEMIA, NEUROACATHOCYTOSIS (abetalipoproteinemia, MCLEOD SYNDROME KELLNULL)

Acanthocyte (spur cell)

BURR CELL/ ECHINOCYTE

RBC with blunt or pointed, short projections that are usually evenly spaced over the surface of cell; present in all fields of blood film but in variable numbers per field

BURR CELL/ ECHINOCYTE

Uremia, pyruvate kinase deficiency

Tear drop (dacrocyte)

RBC WITH A SINGLE POINTED EXTENSION RESEMBLING A TEARDROP OR PEAR

Tear drop (dacrocyte)

PRIMARY MYELOFIBROSIS, MYELOPTHISIC ANEMIA, MEGALOBLASTIC ANEMIA

Diffuse basophilia

Dark blue granules and filaments in cytoplasm (seen in reticulocytes)

DIFFUSED BASOPHILIA

ALSO CALLED, POLY CHROMASIA ;

COMPOSED OF RNA

DIFFUSION BASOPHILIA

HEMOLYTIC ANEMIA, AFTER TREATMENT OF IRON, VITAMIN B12 OR FOLATE DEFICIENCY

Basophilic stippling

DARK BLUE-PURPLE, FINE OR COARSE PUNCTUATE GRANULES DISTRUBUTED THROUGHOUT CYTOPLASM

Basophilic stippling

PRECIPITATED RNA

Basophilic stippling

Lead Poisoning

Thalasemias, HEMOGLOBINOPATHIES, MEGALOBLASTIC ANEMIA, MYELODYSPLASTIC SYNDROME

Howell-Jolly bodies

DARK PURLE DENSE, ROUND GRANULE, USUALLY ONE PER CELL; OCASSIONALLY MULTIPLE

Howell-Jolly bodies

Howell-Jolly bodies

DNA(NUCLEAR FRAGMENT

Howell-Jolly bodies

HYPOSPLENISM

POSTSPLENECTOMY

MEGALOBLASTIC ANEMIA

HEMOLYTIC ANEMIA

THALASSEMIA

MYELODYSPLASTIC SYNDROME

HEINZ BODY

ROUND, DARK PURPLE GRANULE ATTACHED TO INNER RBC MEMBRANE

Heinz body and Hb H

NOT VISIBLE IN WRIGHT STAIN

HEINZ BODY

denatured hemoglobin

HEINZ BODY

G-6-PD

UNSTABLE HEMOGLOBIN

OXIDANT DRUGS AND CHEMICALS

Pappenheimer bodies

IRREGULAR CLUSTERS OF SMALL, LIGHT TO DARK BLUE GRANULES OFTEN NEAR PERIPHERY

Pappenheimer bodies

composed of iron

Pappenheimer bodies

Sideroblastic anemia, hemoglobinopathies , THALASSEMIAS

MEGALOBLASTIC ANEMIA, MYELODYSPLASTIC ANEMIA, HYPOSPLENISM, POST SPLENECTOMY

CABOT RING

Rings or figure-eights

- Remnants of mitotic spindle

CABOT RING

MEGALOBLASTIC ANEMIA, MYELODYSPLASTIC SYNDROME

CABOT RING

HB H

Precipitate of beta chains of hemoglobin

HB H

HBH DSE