haematology - peripheral blood smears Flashcards
acanthocytes
RBCs show spicules
acanthocytes suggests
liver disease
hyposplenism
abetalipoproteinaemia
basophilic RBC stippling
small dots at the periphery (rRNA)
accelerated erythropoiesis/defective Hb synthesis
basophilic RBC stippling suggests
lead poisoning megaloblastic anaemia myelodysplasia liver disease haemoglobinopathy (eg. thalassaemia)
Burr cells (echinocytes)
sea urchin with regular spicules
Burr cells (echinocytes) suggests
artefacts if sample sat in EDTA prior to film
uraemia
GI bleeding
stomach carcinoma
Heinz bodies
inclusions on very edge of RBCs
due to denatured Hb
Heinz bodies suggests
G6PD deficiency
chronic liver disease
Howell-Jolly bodies
Basophilic (purple) nuclear remnants in RBCs
Howell-Jolly bodies suggests
post-splenectomy
hyposplenism
- SCD, coeliac, congenital, UC/Crohn’s, myeloproliferative disease, amyloid
megaloblastic anaemia
hereditary spherocytosis
Leucoerythroblastic anaemia
presence of nucleated RBCCs and myeloid precursors
Leucoerythroblastic anaemia suggests
marrow infiltration
- myelofibrosis
- malignancy
Pieger Huet Cells
hypo segmented neutrophil with 2 lobes like a dumbell
Pieger Huet Cells suggests
congenital
- lamin B receptor mutation
acquired
- myelogenous leukaemia
- myelodysplastic syndromes
Polychromasia
bluish RBCs due to DNA presence
usually reticulocytes (immature RBCs)
polychromasia suggests
natural response to shortened RBC life
↑ haemolytic anaemia
↓ aplastic anaemia, chemo
right shift
hyper mature white cells
hyper-segmented polymorphs (>5 lobes to nucleus)
right shift suggests
megaloblastic anaemia
uraemia
liver disease
rouleaux formation
stacked RBCs
rouleaux formation suggests
chronic inflammation
paraproteinaemia
myeloma
schistocytes
fragmented parts of RBCs
sharp edges
no central pallor
schistocytes suggests
microangiopathic anaemia
- DIC
- HUS
- thrombotic thrombocytopenia purpura
- pre eclampsia
spherocytes
sphere shaped RBCs
often smaller
spherocytes suggests
hereditary shperocytosis
autoimmune haemolytic anaemia
stomatocytes
central pallor is straight/curved rod
‘smiley face’/’fish mouth’ RBCs
stomatocytes suggests
artefact
hereditary stomatocytosis
high alcohol intake
liver disease
target cells (codocytes)
bull’s eye appearance in central pallor
target cells (codocytes) suggests
liver disease
hyposplenism
thalassaemia
IDA
