Hematopoiesis Flashcards
(i.e., normal size and shape) are biconcave discs usually about 6-8 m in diameter (about the same diameter as the nucleus of a small lymphocyte).
normocytic erythocytes
(i.e., normal hemoglobin content) have a center somewhat paler than the peripheral rim of the cell
normochromic erythrocytes
homogenous population of normochromic erythrocytes
normocytic normochromic
demonstrate a central pale area that becomes larger and paler as the hemoglobin content diminishes.
hypochromic erythrocytes
indicates the presence of both normochromic and hypochromic cells in the same blood film
anioschromia or dimorphic
abnormally small erythrocytes (i.e., less than 6 m in diameter).
microcytes
abnormally large erythrocytes (i.e., greater than 8 m in diameter)
macrocytes
“generic” term used to indicate an abnormal variation in size of erythrocytes.
anisocytosis
are oval-shaped erythrocytes and are abundant in hereditary ___
Elliptocytes (ovalocytes)
Lesser amounts of elliptocytes seen in?
A lesser number are seen in thalassemia, aplastic anemia, leukemia, and macroovalocytes in megaloblastic anemia
are irregularly contracted erythrocytes which stain densely and have contraction of hemoglobin from a part of the cell membrane, thereby giving the appearance that a “bite” has been take out of the cells.
keratocytes (“bitocytes”)
When do we see keratocytes?
seen in G6PD deficiency and are thought to be cells from which Heinz bodies have been removed from the spleen.
They are small pieces of cells cut from whole cells with a cell size less than one half of normal size. The segments can be a variety of shapes but helmet cells and triangle-shaped cells are particularly characteristic.
Schistocytes (fragmented red cell segments)
What causes the creation of schistocytes (fragmented red cell segments)?
hemolytic process (e.g. disseminated intravascular coagulation, hemolytic uremic syndrome, etc.).
are nearly spherical small dark hemoglobinized cells without a central pale area
spherocytes
When do we see spherocytes?
prominent in hereditary spherocytosis, autoimmune hemolytic anemia, burns, thermal sensitivity
Where do we see less spherocytes?
any anemia
are abnormal RBC’s with a central, pale, cresent shaped area that resembles a mouth
stomatocytes
When do we see stomatocytes?
Rh disorders
erythrocytes that are thinner than normal which show a peripheral rim of hemoglobin with a dark, central hemoglobin-containing area. A pale unstained ring containing less hemoglobin separates the central and peripheral zones and gives the cell a target appearance. These cells have increased (redundant) surface membrane with increased lecithin and cholesterol content.
target cells (codocytes)
look like teardrops. They are elongated cells that have one round end with the other end tapering off to a smaller point
teardrop-shaped cells (dacrocytes)
What are teardrop-shaped cells associated with? macroteardrops?
with myelofibrosis. A few are typically associated with thalassemia and may be seen in other types of anemias.
Macroteardrops are associated with megaloblastic anemia.
Erythrocytes with round or spiny spicules (projections) may be classified as?
crenated red cells, acanthocytes, spur cells, burr cells, or pyknocytes by some authors based upon the number and shape of the spicules
resemble spherocytes with peripheral irregularly spaced spiny or thorny projections
acanthocytes
When do we see acanthocytes?
severe liver disease, infantile pykno-cytosis (with underlying hemolytic process), abetalipoproteinemia, or anorexia nervosa.
appear as irregularly shaped red cells with numerous small, thorny projections and preserved central pallor.
echinocytes
How do we get echinocytes?
usually an artifactual phenomenon, they may be produced by lysins, sphering agents, or increases in pH
When do we see echinocytes?
in liver and renal disease, hyperlipidemia, and red cell enzymopathies.
mature red cells of approximately normal size with central pallor and one or more spiny projections
burr cells (keratocytes)
When do we see burr cells?
uremia, bleeding peptic ulcer, heart valve replacement, vasculitis, DIC, and microangio-pathic hemolytic anemia
red blood cells are symmetrical with heavy, coarse, scalloped edges (i.e., uniformly shrunken red cells with uniform irregular, wrinkled cell membranes).
crenated
How do we get crenated RBCs? How differ from echinocytes?
artifact of storage and all red cells in the field are usually affected. By contrast, echinocytes are intermixed with normal red cells).
How to differentiate artifacts resembling crenated cells (may be seen when a small amount of water has contaminated the Wright-Giemsa stain)?
The erythrocytes will appear to have a tiny pit or bubble indentation.
“generic” term used to indicate an abnormal variation in erythrocyte shapes, which may include combinations of normal, oval, pear, teardrop, saddle, helmet, sickle, and irregular shapes.
Poikilocytosis
formation describes an aggregation of erythrocytes that are aligned one upon the other resembling stacks of coins and is caused by elevated plasma fibrinogen or globulins. This phenomenon causes an increased erythrocyte sedimentation rate
rouleau
Rouleau is characterstic of what?
paraproteinemia (monoclonal gammopathy)
caused by agglutinins and resembles rouleau but is more irregular with round clumps rather than linear rouleau
agglutination of red cells
are elongate hexagonal crystals, which may be intracellular or extracellular
Hemoglobin C crystals
When do we see hemoglobin C crystals?
HbC syndromes
indicate the presence of irregular basophilic granules (polyribosomes), which may be coarse or fine, within the mature or immature erythrocyte.
basophilic stippling
When do we see basophilic stippling?
seen in normal smears
intracellular inorganic iron-containing granules that may be observed on Wright’s stained peripheral blood smears
pappenheimer bodies
When the pappenheimer bodies are demonstrated by stains for iron (e.g., Prussian Blue), the cells are called ___?
siderocytes
When do we see pappenheimer bodies? particularly sideocytes?
iron-loading anemias (e.g., thalassemia)
Siderocytes may be found in large numbers when hemoglobin synthesis is impaired (as in siderochrestic anemias) and after splenectomy. They may also be seen in iron-loading anemias, hyposplenism, and in hemolytic anemias of various etiologies
intracellular particles that are smooth, round remnants of nuclear chromatin (DNA). Usually, only one per cell is seen but, occasionally, there may be more than one.
howell-jolly bodies
appear as intracellular red or reddish purple structures that are usually shaped like rings, loops, figure-of-eight with no internal structure
cabot rings
precursors of the non-nucleated mature red cells. The orthochromatic erythroblast is the stage usually noted observed in peripheral blood in disease states, but less mature stages may also be seen
nucleated red blood cells (NRBC)
What stain is needed to see reticulocytes and Heinz bodies?
supravital stain (e.g. crystal violet, new methylene blue stain)
After staining, the cytoplasmic organelles of the cells (RNA) clump into an easily recognized blue-staining reticulum, which allows an accurate count of ____ to be made.
reticulocytes
What does an increase in reticulocytes indicate? Characteristically seen when?
best indication that the bone marrow is functioning and responding to a demand for increased release of erythrocytes into circulation
hemolytic anemias
appear as precipitates of denatured hemoglobin which characteristically adhere to the red cell membrane
Heinz bodies
Heinz bodies are characteristically seen in?
G6-PD deficiency anemia
