Blood film findings Flashcards
what is basophilic stippling?
blue staining of ribosomes in the cytoplasm of RBCs
what is BS seen in?
megaloblastic anaemia
thalassaemia
sideroblastic anaemia
alcohol abuse
what does BS suggest?
disturbed rather than increased red cell production
what are Howell-Jolly bodies?
small single peripherally located rounded inclusions in erythrocytes
what does the presence of HJBs indicate?
HYPOSPLENISM
where are functional and true HJBs found?
functional - within spleen
true - assc. with splenectomy
what are shistocytes?
fragments of RBCs
what does the presence of schistocytes indicate?
microangioplastic haemolytic anaemia (MAHA)
what do shistocytes look like?
irregularly shaped, jagged, two pointed ends
what is a left shift?
immature white cell
what is left shift seen in?
acute infection
severe -> CML, myelofibrosis or AL
what does right shift signify?
prevalence of hyper-mature neutrophils with more than 5 lobes
what is right shift seen in?
chronic infections
G-CSF - meds
hyperpigmented neutrophils - megaloblastic anaemia
what is reticulocytosis?
increase in reticulocytesw
what are reticulocytes?
immature RBCs, just left bone marrow, RNA remnants, no nucleus
when does reticulocytosis occur?
compensation for red cell loss -> bleeding, haemolysis
marrow starved -> iron, B12 or folate - anaemia, macrocytic anaemia, pernicious anaemia
what are codocytes (target cells) seen in?
obstructive liver disease
haemoglobinopathies (thalassaemia and sickle cell)
post-splenectomy
what is rouleaux formation?
stacks of aggregated (clumped) RBCs
when does rouleaux formation occur?
when plasma conc is high
what is RF seen in?
multiple myeloma
Waldenstrom’s macroglobulinaemia
inflammatory disorders
malignancies
what is leukoerythroblastosis?
combined presence of immature RBCs and immature WBCs
what is leukoerythroblastosis seen in?
marrow fibrosis
invasion
primary myelofibrosis
metastatic cancer
TB
Gaucher’s disease
what is anisocytosis?
variation in RBC size - quantified by EC distribution risk
what is common cause of anisocytosis with low MCV?
iron deficiency
sickle cell anaemia
anaemia of chronic disease
thalassaemia
what is common causes of anisocytosis with high MCV?
megaloblastic anaemias
haemolysis with reticulocytosis
myelodysplasia
liver disease
what are acanthocytes (spur cells)?
RBCs spiked in film
what doe spur cells occur due to?
altered lipid or protein composition of RBCs plasma membrane
what are spur cells seen in?
liver disease
neurocanthocytosis
anorexia nervosa
hypothyroidism
myelodysplasia
what are cabot rings?
rounded RBC inclusions, slender loops seen in cytoplasm
what are cabot rings seen in?
megaloblastic anaemia
severe anaemia
lead poisoning
leukaemia
pernicious anaemia
what are burr cells?
RBCs with small regularly distributed projections across cell surfacer
what di burr cells occur due to?
extrinsic effect of changed in composition of plasma membrane
what are burr cells seen in?
liver disease
vitamin E deficiency
end-stage renal disease
pyruvate kinase deficiency
