HEME (Pathological RBC Forms)

Question 0

Acanthocyte (“Spur” cell)

Seen In (2)?

Answer 0

SEEN IN:

• Abetalipoproteinemia (states of cholesterol dysregulation)
• Liver dz

Question 1

“Rigid” RBCs

Answer 1

PK Deficiency

Question 2

Auer Rods

Def’n, Seen In?

Answer 2

Azurophilic Peroxidase+ granular inclusions in myeloblasts + granulocytes.

SEEN IN:
- AML (esp M3 type)

Question 3

Basophilic Stippling

Def’n, Seen In (4: “Basically, ACiD Alcohol is LE THAL”)

Answer 3

RBCs retain aggregates of rRNA.

SEEN IN:

• Anemia of Chronic Disease
• Alcohol abuse
• Lead poisoning
• Thalassemias

Question 4

Bite Cell

Mech of Formation, Seen In?

Answer 4

Spleen Macrophages removes Heinz Bodies ->
“Bitten” appearance of RBCs.

SEEN IN:
- G6PD deficiency

Question 5

Dacrocyte (“Teardrop” cell)

** RBC “sheds a tear” because it’s been forced out
of its home (BM). **

Seen In (2)?

Answer 5

SEEN IN:

• BM infiltration (eg Myelofibrosis) / scarring (Myelophthisis)
• Spleen dysfunction

Question 6

Echinocytes (“Burr” cells)

Seen In?

Answer 6

SEEN IN:

- Uremia

Question 7

Elliptocyte / Ovalocyte

Seen In?

Answer 7

SEEN IN:

- Hereditary Elliptocytosis

Question 8

Heinz Bodies

Def’n, Mech of Formation (4 steps), Seen In (2)?

Answer 8

Oxidized Hb precipitated within RBCs.

MECH:
Susceptibility of Hb to OX STRESS
(Fe from ferrous to ferric form + formation of sulfahydryl groups) ->
Hb DENATURED ->
Denatured Hb PRECIPITATES as “Heinz Bodies” ->
Damage to RBC membrane.

SEEN IN:

• a-thalassemia (Heinz Body-like inclusions)
• G6PD deficiency

Question 9

Howell-Jolly Bodies

Def’n, Appearance, Seen In?

Answer 9

Basophilic nuclear remnants found in RBCs.
(Normally removed from RBCs by splenic macrophages)

Blue-black inclusions.

SEEN IN:
- Asplenia / Hyposplenia (ie spleen dysfunction)

Question 10

Macro-Ovalocyte

Seen In?

Answer 10

SEEN IN:

- Macrocytic Megaloblastic Anemia

Question 11

Nucleated RBCs

Seen In?

Answer 11

SEEN IN:

- Myelofibrosis

Question 12

Pappenheimer Bodies

Seen In?

Answer 12

SEEN IN:

- Sideroblastic Anemia

Question 13

Ringed Sideroblasts

Mech of Formation, Seen In?

Answer 13

Pathological excess of IRON in mitochondria.

SEEN IN:
- Sideroblastic Anemia

Question 14

Rouleaux Formation of RBCs

Def’n, Mech, Seen In?

Answer 14

RBCs stacked like poker chips.

↑serum protein decreases charge between RBCs.

SEEN IN:
- Multiple Myeloma

Question 15

Schistocyte (“Helmet” cell)

Mech of Formation (3 steps), Seen In (8)?

Answer 15

** “Fragmented” cells / “Helmet” cells **
Path formation of PLATELET MICROTHROMBI in small vessels
-> RBCs “SHEARED” as they cross these microthrombi
-> Hemolytic Anemia with Schistocytes.

SEEN IN:
- B-Thalassemia
- INTRAvasc + Traumatic Hemolysis
  (mech destruction of RBCs, eg mechanical heart valve prosthesis)
- Enz def: G6PD + PK def
- Micro- + Macroangiopathic Hemolytic Anemias
- DIC
- TTP/HUS
- Malignant Htn
- SLE

Question 16

Sickle Cell Disease

Def’n (Sickle Cells), Genetics, Mech of Formation (4 steps),
Seen In, Comp?

Answer 16

Sickle cells = crescent-shaped RBCs.

Missense DNA mutation.

Sickle Cell Anemia with 2 abnormal β genes present ->
>90% HbS in RBCs ->
HbS POLYMERIZES when deoxygenated ->
Polymers aggregate into needle-like structures = “Sickle Cells”.

SEEN IN:
- Sickle Cell Anemia

COMP:
- Osteonecrosis

Question 17

Spherocyte

Mech of Formation (3 steps), Seen In (2)?

Answer 17

TOO LITTLE MEMB ->
RBC can’t maintain biconcave disc shape ->
Forms sphere. No area of pallor

SEEN IN: (Extravascular Hemolysis)

• Autoimmune Hemolytic Normocytic Anemias
• Hereditary Spherocytosis

Question 18

Stomatocytes

Seen In?

Answer 18

SEEN IN:

- Hereditary Stomatocytosis (Alcoholism)

Question 19

Target Cell

Mech of Formation (3 steps), Seen In (4), Marker of (2)?

Answer 19

INTRAvascular hemolysis ->
TOO MUCH MEMB ->
RBC able to hold MORE HB.

SEEN IN: ** “HALT said the hunter to his target” **

• HbC defect (Hemolytic Normocytic Anemia)
• Asplenia
• Liver disease
• Thalassemias

MARKER OF:

• Hb-opathies
• Alcoholism