MODULE 6 UNIT 1: RED BLOOD CELL ANOMALIES Flashcards
impaired synthesis
- hemoglobin
- DNA
- heme
- MICROCYTE
- MACRICYTE
- Pappenheimer Bodies
excess surface membrane
MACRICYTE
Target cells
erythropoietic activity
- stress
- increased
- elevated
- impaired
- MACRICYTE
- POLYCHROMIA
- Basophilic Stippling
more than one color; blue-gray discoloration of a red cell
POLYCHROMIA
– absorbs the alkaline stain
RNA remnants
No central pallor
HYPERCHROMIA
Spherocytes
Microspherocytes or pyropoikilocytes
Drepanocyte
sour cells or thorn cells
Acanthocytes
spheroid
Acanthocytes
Acanthocytes
no. of irregular spikes/spicules
3-12
o abnormal ratios of membrane lecithin and sphingomyelin
Acanthocytes
o increased ratio of cholesterol to lecithin
Acanthocytes
burr cells, crenated cells or sea urchin cells
Echinocytes
red cells with regular 10-30 scalloped short projections
Echinocytes
occur due to depletion of ATP and exposure to hypertonic salt solution
Echinocytes
appear as artifacts in air drying
Echinocytes
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 or pyropoikilocytes
d. Semi-lunar bodies
Poikilocytes secondary to abnormal hemoglobin content
a. Drepanocyte
RED CELL INCLUSIONS
- Howell-Jolly Bodies
- Basophilic Stippling
- Cabot Rings
- Heinz Bodies
- Hb H Inclusions
- Hb CC Crystals
- Hb SC Crystals
- Pappenheimer Bodies
- Parasites
MISCELLANEOUS
- Autoagglutination
- Rouleaux Formation
Mexican hat cells
Target cells
bell or tall hat shaped cells on scanning electron microscope
Target cells
show a peripheral rim of hemoglobin surrounded by a clear area and central hemoglobinized area
Target cells
o bull’s eye appearance
Target cells
codocytes
Target cells
o due to excess surface membrane to volume ratio or increased cholesterol and phospholipids
Target cells
rod or cigar shaped
Elliptocytes
narrower than ovalocytes
Elliptocytes
Defects in the polymerization of hemoglobin that cause defects in the cytoskeleton or decreased membrane protein band 4.1
Elliptocytes
egg-like or oval-shaped
Ovalocytes
wider than elliptocytes
Ovalocytes
change in shape is due to a bipolar arrangement of hemoglobin or reduction of membrane cholesterol
Ovalocytes
smaller red cells with concentrated hemoglobin
Spherocytes
Defective membrane (spectrin deficiency) that cause the lowest surface area to volume ratio
Spherocytes
Banked blood stored for a long time due to storage lesions
Spherocytes
mouth cells
Stomatocytes
hydrocytes
Stomatocytes
slit-like pallor
Stomatocytes
bowl-shaped
Stomatocytes
cloven or split
schistos or schizo
fragmented red cells varying in size and shape
Schistocytes/Schizocytes
hornlike projections
keratocytes/helmet cells
– triangular with two (2) pallor areas
knizocytes
Extreme fragmentation of red cells in Schistocytes/Schizocytes is caused by:
o presence of fibrin in the blood vessels
o altered vessel walls
o prosthetic heart valves
Schistocytes/Schizocytes two variants
keratocytes/helmet cells
knizocytes
tear-drop cells
Dacrocytes
pearshaped cells with elongated point or tail
Dacrocytes
morphological change happens during squeezing or fragmentation of the red cells during splenic passage
Dacrocytes
ruptured or fragmented
Schistocytes/Schizocytes
Microspherocytes or pyropoikilocytes
Heinz Bodies
red blood cells with smaller diameter that ruptures at a much lower temperature (450C) than a normal red cell (fragments at 490C)
Microspherocytes or pyropoikilocytes
half-moon/crescent cells
Semi-lunar bodies
large, pale pink staining ghosts of the red cells
Semi-lunar bodies
form when the red cell membrane is disrupted causing the release of its content
Semi-lunar bodies
Ghost cells
Semi-lunar bodies
sickle cells
Drepanocyte
cresentshaped cells
Drepanocyte
Semi-lunar bodies
defect lies in the abnormal polymerization of deoxygenated hemoglobin due to the presence of an abnormal hemoglobin compound
Drepanocyte
dot like inclusions inside red cells
Howell-Jolly Bodies
coarse, round densely stained purple granules
Howell-Jolly Bodies
1-2 um in size
Howell-Jolly Bodies
eccentrically located on the periphery of the red cell membrane
Howell-Jolly Bodies
may be found singly or in twos in a singular red cell
Howell-Jolly Bodies
nuclear remnants that contain DNA
Howell-Jolly Bodies
Causing punctuate basophilia in the red cell
Basophilic Stippling
round, dark blue granules that are uniformly distributed
Basophilic Stippling
caused by precipitation of ribosomes and RNA in the cell
Basophilic Stippling
o ↑ polychromatophilia
o ↑ production of red cells
Fine stippling
: o caused by instability of RNA in a young cell
Coarse stippling
thread-like structure inside red cell
Cabot Rings
may present as rings, loops, or figures of eight
Cabot Rings
red to purple in color
Cabot Rings
remnants of the microtubules of the mitotic spindle
Cabot Rings
precipitation of denatured hemoglobin due to oxidative injury
Heinz Bodies
2-3 um in size
Heinz Bodies
Pappenheimer Bodies
deep purple
Heinz Bodies
found on the inner surface of the cell membrane
Heinz Bodies
Multiple bodies can give a pitted golf-ball appearance to a cell
Heinz Bodies
Only seen supravitally
Heinz Bodies
Hb H Inclusions
Precipitation of Hb H is caused by Alpha-thalassemia otherwise known as Hb H disease
Hb H Inclusions
appear as clam shells
Hb CC Crystals
darkly staining hexagonal crystals with blunt ends
Hb CC Crystals
dark-hued crystals of condensed Hb
Hb SC Crystals
distort the red cell membrane
Hb SC Crystals
A crystal can create a projection that is often straight with parallel sides:
o one blunt end
o one pointed protruding end
Hb SC Crystals
resemble a Washington monument shape
Hb SC Crystals
siderotic granules
Pappenheimer Bodies
represent the unused iron deposits in the body due to defects in heme synthesis
Pappenheimer Bodies
irregular blue inclusions
Pappenheimer Bodies
aggregate in small clusters near the periphery of the cell
Pappenheimer Bodies
parasites that can be seen in blood include:
o hemoflagellates (Leishmania species and Trypanosoma species)
o malaria (Plasmodium species)
o Babesia species
Depending on the stages, they can be distinctly identified when they are present inside the red cells
Parasites
a phenomenon when red cells aggregate into random clusters or masses due to exposure to various cell antibodies
Autoagglutination
red cells agglutinate in the body’s own plasma or serum that contains no specific known agglutinins
Autoagglutination
stack of coin arrangement
Rouleaux Formation
o altered zeta potential
Rouleaux Formation
o ↑ plasma proteins
Rouleaux Formation