Hema 1 Part 2 1 Flashcards
PURPOSES OF BLOOD FILM EXAMINATION
• To differentiate mature from immature blood cells
• To assess morphology of the blood cells
• To perform manual differential count
AS THE BLOOD CELL MATURES…
Chromatin Pattern
Nucleoli
N:C Ratio (Nucleus:Cytoplasm Ratio)
Cell Size
Cytoplasmic Basophilia
RECALL QUESTION: What is the most reliable indicator of maturity?
Chromatin pattern
RBC MORPHOLOGY
• Normal size of RBC:
• Normal RBC shape:
• Normal RBC color/pallor:
RBC MORPHOLOGY
• Normal size of RBC: 6-8 um in diameter
• Normal RBC shape: Discocyte / Biconcave Disc
• Normal RBC color/pallor: 1/3 central pallor
Variation in the size of RBCs
ANISOCYTOSIS
Anisocytosis can be assessed using
RDW (Red Cell Distribution Weight)
MACROCYTES diseases ( ↑ MCV)
• Megaloblastic Anemia
• Liver Disease
• Shift Cells
MICROCYTES ( ↓ MCV)
• Iron Deficiency
Anemia (IDA)
• Thalassemia
• Chronic Blood Loss
→ Due to
gastrointestinal
bleeding
Major site of hematology
Bone marrow:
Parameter that will give an idea if there are macrocytes present
MCV
Variation in the shape of RBCs
POIKILOCYTOSIS
Variation in the color/pallor of RBCs
ANISOCHROMIA
Hematopoietic stem cell marker:
CD34
Regulated by erythropoietin, which is produced by the
kidneys
Main site of adult hematopoiesis or blood cell production are the following:
→ Vertebrate
→ Ribs
→ Sternum
→ Skull
→ Proximal ends of the femur and humerus
• “Spur cells”
• Large, irregular, blunt projections
Acanthocyte
Acanthocyte Found in patients with:
→ Abetalipoproteinemia (Bassen–Kornzweig
Syndrome)
→ McLeod phenotype (Kell Blood Group System)
▪ Rare phenotype
• “Burr cells”
• Projections are not as big as acanthocytes
• Spicules are more pointed and evenly distributed
Echinocytes
Echinocytes seen in
RECALL QUESTION: Seen in:
→ Uremia
→ Kidney problems
Teardrop RBCs
Dacrocytes
Dacrocytes Found in cases of:
Myeclotibosis / Myeloid metaplasia
“Sickle cell”
• Crescent, Banana shaped
Drepanocytes
Drepanocytes seen in
Hbs positive individuals
Hemolyzed RBC fragments / Debris
Schizocytes
Schizocytes Found in
→ Hemolytic anemia
→ Burns
Horn-like / Helmet-like RBC
Keratocytes
Keratocytes Found in:
Hemolytic Anemia
Mouth-like or slit-like appearance on top view; bowl-like
appearance on side view since it has a depression and not
an opening
Stomatocytes
Stomatocytes Seen in:
Hereditary stomatocytosis
Individuals with liver disease
Rh null phenotype
Target cells; Mexican hat cell
→ Dartboard appearance since it has an alternating
RBCs take in without
staining characteristics.
▪ Dartboard appearance is due to the multiple
curves of the codocytes
Codocytes
Codocytes seen in
→ Thalassemia
→ Hemoglobinopathy
Ovalovutes are seen in
→ Parasitic Infection
▪ Plasmodium infections (P. ovale)
→ Megaloblastic anemia
Which poikilocyte is found on
a. Macrocyte
b. Macro-ovalocyte
B
• RBCs that lacks central pallor
Spherocytes
Spherocytes conditions
Conditions:
→ Hereditary spherocytosis
→ Autoimmune hemolysis anemia (AIHA)
→ HDN - ABO shows the presence of spherocytes
→ HTR
Made up of DNA fragments
Howell Jolly
bodies
Howell Jolly bodies test
Feulgen stain positive
Howell Jolly bodies Seen in condition in patients with:
Megaloblastic Anemia (Impaired DNA synthesis)
