MODULE 6: BLOOD CELL ANOMALIES Flashcards
A. VARIATION IN SIZE
ANISOCYTOSIS
ANISOCYTOSIS
Indicators of normal cell size:
i. Cell diameter
ii. Mean Corpuscular Volume (MCV)
iii. Red Cell Distribution Width
ANISOCYTOSIS
i. Cell diameter
ii. Mean Corpuscular Volume (MCV)
iii. Red Cell Distribution Width
6-8 µm
80-100 fL
11-14%
MICROCYTE
i. Cell diameter
ii. Mean Corpuscular Volume (MCV)
<6 um
<80 fL
MACROCYTE
i. Cell diameter
ii. Mean Corpuscular Volume (MCV)
> 8 um
100fL
B. VARIATION IN COLOR (HEMOGLOBIN CONTENT)
ANISOCHROMIA
ANISOCHROMIA
i. MCHC
ii. Central pallor
32-36 g/dL
1/3 of the red cell diameter
HYPOCHROMIA
i. MCHC 32-36 g/dL
ii. Central pallor 1/3 of the red cell diameter
<32-36 g/dL
>1/3
HYPERCHROMIA
i. MCHC 32-36 g/dL
ii. Central pallor 1/3 of the red cell diameter
> 32-36 g/dL
Absent
more than one color RNA remnants
blue-gray discoloration of a red cell absorbs the alkaline stain
POLYCHROMIA
absorbs the alkaline stain
RNA remnants
failure of hemoglobin synthesis
MICROCYTE
Anemia of Chronic Disease
Thalassemia
Iron Deficiency Anemia
Sideroblastic Anemia
MICROCYTE
impaired DNA synthesis
stress erythropoiesis
excess surface membrane
MACROCYTE
Megaloblastic anemia
Liver disease
MACROCYTE
Thalassemia
Iron Deficiency Anemia
HYPOCHROMIA
Spherocytosis
Macrocytosis
HYPERCHROMIA
increased erythropoietic activity
Hemolytic anemia
Physiologic need
POLYCHROMIA
C. VARIATION IN CELL SHAPE
POIKILOCYTOSIS
C. VARIATION IN CELL SHAPE POIKILOCYTOSIS
Indication of a normal shape:
biconcave disc-shape
- Poikilocytes secondary to membrane abnormalities
a. Acanthocytes
b. Echinocytes
c. Target cells or Codocytes
d. Elliptocytes
e. Ovalocytes
f. Spherocytes
g. Stomatocytes
- Poikilocytes secondary to trauma
a. Schistocytes/Schizocytes
b. Dacrocytes
c. Microspherocytes
d. Semi-lunar bodies
- Poikilocytes secondary to abnormal hemoglobin content
a. Drepanocyte
D. RED CELL INCLUSIONS
- Howell-Jolly Bodies
- Basophilic Stippling
- Cabot Rings
- Heinz Bodies
- Hb H Inclusions
- Hb CC Crystals
- Hb SC Crystals
- Pappenheimer Bodies
- Parasites
E. MISCELLANEOUS
- Autoagglutination
- Rouleaux Formation
A. RBC Distribution and Size
- Agglutination
- Rouleaux Formation
- More than 50% microcytosis seen in an oil immersion field (in reference to MCV)
- More than 50% macrocytosis in an oil immersion field (in reference to MCV)
- Less than 50% microcytes or macrocytes in an oil immersion field (in reference to RDW)
B. RBC QUALITATIVE ABNORMALITIES
- Hypochromia
- Polychromia
- Large Number of Poikilocytes
- Small Number of poikilocytes
C. DIAGNOSTIC ABNORMALITIES and INCLUSIONS
- Basophilic Stippling
- Howell-Jolly and Pappenheimer Bodies
- Nucleated RBCs
- Malarial Parasites
agglutination disappears after warming the sample
“cold agglutination present”
agglutination persists after warming
“RBC agglutination present”
- Rouleaux Formation
Slight
Moderate
Marked
intermittent stacks of 4-8 RBCs
Frequent stacks of 4-8 RBCs
Many stacks of RBCs
- More than 50% microcytosis seen in an oil immersion field (in reference to MCV)
Slight
Moderate
Marked
76 fL to 79 fL
66 fL to 75 fL
<66 fL
- More than 50% macrocytosis in an oil immersion field (in reference to MCV)
Slight
Moderate
Marked
101 fL to 108 fL
109 fL to 120 fL
>120 fL
- Less than 50% microcytes or macrocytes in an oil immersion field (in reference to RDW)
Slight
Moderate
Marked
16 to 18
18 to 22
>22