Pathologic RBC forms

Question 1

Acanthocyte

Answer 1

“Spur cell”

- associated with liver disease, abetalipoproteinemia (states of cholesterol dysregulation)

Question 2

basophilic stippling

Answer 2

lead poisoning

Question 3

degmacyte

Answer 3

aka “bite cell”

- G6PD deficiency

Question 4

elliptocyte

Answer 4

hereditary elliptocytosis (RBC look oval)

Question 5

macro-ovalocyte

Answer 5

megaloblastic anemia (also hypersegmented PMNs), marrow failure

Question 6

ringed sideroblast

Answer 6

sideroblastic anemia. Excess iron in mitochondria = pathologic

bluish ring around cell nucleus

Question 7

schistocyte

Answer 7

“helmet cell” (looks like pacman ghost)

- DIC, TTP/HUS, HELLP syndrome, mechanical hemolysis (e.g., heart valve prosthesis)

Question 8

sickle cell

Answer 8

sickle cell anemia; sickling occurs with dehydration, deoxygenation, and at high altitude

Question 9

spherocyte

Answer 9

hereditary spherocytosis, drug and infection-induced hemolytic anemia

Question 10

dacrocyte

Answer 10

“teardrop cell”

• bone marrow infiltration (e.g. myelofibrosis)
• RBC sheds a tear because its mechanically squeezed out of its home in bone marrow

Question 11

target cell

Answer 11

HbC disease, Asplenia, Liver disease, Thalassemia

- “HALT said the hunter to his target”

Question 12

Heinz Bodies

Answer 12

Oxidation of Hb-SH groups to -S–S- leads to Hb precipitation into Heinz bodies with subsequent phagocytic damage to RBC membrane —bite cells

seen in G6PD deficiency; Heinz body-like inclusions seen in alpha thalassemia

Question 13

Howell-Jolly Bodies

Answer 13

basophilic nuclear remnants found in RBCs. Normally removed from RBCs by splenic macrophages

• seen in pts with funcitonal hyposplenia or asplenia