Pathologic RBC forms

Question 1

Answer 1

Acanthocyte (spur cell)

Liver disease, abetalipoproteinemia (cholesterol dysregulation)

Acantho = spiny

Question 2

Answer 2

Basophilic stippling

[Baste the ox TAiL]

Thalassemia, Anemia of chronic disease, Lead poisoning

Question 3

Answer 3

Bite Cell

G6PD Deficiency

Question 4

Answer 4

Elliptocyte

Hereditary elliptocytosis

Question 5

Answer 5

Macro-ovalocyte

Megaloblastic anemia (also hypersegmented PMNs), marrow failure

Question 6

Answer 6

Ringed sideroblasts

Sideroblastic anemia
Excess iron in mitochondria = pathologic

Question 7

Answer 7

Schistocyte, helmet cell

DIC, TTP/HUS, traumatic hemolysis (metal heart valve prosthesis)

Question 8

Answer 8

Sickle cell

Sickle cell anemia

Question 9

Answer 9

Spherocyte

Hereditary spherocytosis, autoimmune hemolysis

Question 10

Answer 10

Teardrop cell

Bone marrow infiltration (e.g. myelofibrosis)

Question 11

Answer 11

Target cell

[HALT says the hunter]

HbC disease, Asplenia, Liver disease, Thalassemia

Question 12

Answer 12

Heinz bodies

G6PD; Heinz body-like inclusions in alpha-thalassemia

Oxidation of iron from ferrous to ferric leads to denatred hemoglobin precipitation and damage to RBC membrane -> formation of bite cells

Question 13

Answer 13

Howell-Jolly bodies

Functional hyposplenia or asplenia; after mothball ingestion (naphthalene)

Basophilic nuclear remnants in RBCs
Normally removed from RBCs by splenic macrophages

Question 14

Answer 14

Iron deficiency. Note microcytosis and hypochromia

Question 15

Answer 15

Beta-thalassemia major

Note anisocytosis, poikilocytosis, microcytosis, hypochromia, target cells and schistocytes

Question 16

Answer 16

Sickle cell disease

Question 17

Answer 17

Reed-Sternberg Cells

2 halves as mirror images (“owl’s eyes”)
See in Hodgkin’s disease

Question 18

Answer 18

Burkitt’s lymphoma

“Starry sky” appearance: sheets of lymphocytes with interspersed macrophages

Question 19

Answer 19

Multiple myeloma

Monoclonal plasma cell (“fried egg” appearancce)
Clock face chromatin (black arrow) and whitish intracytoplasmic inclusions containing immunoglobulin

Question 20

Answer 20

Acute Lymphoblastic Leukemia/Lymphoma

Question 21

Answer 21

Small lymphocytic lymphoma/Chronic lymphocytic leukemia

Smudge cells in peripheral blood smear

Question 22

Answer 22

Hairy cell leukemia

Cells have filamentous, hair-like projections

Question 23

Answer 23

Acute myelogenous leukemia

Question 24

Answer 24

Chronic myelogenous leukemia (CML)

Increased in neutrophils, metamyelocytes, basophils

Question 25

Answer 25

Birbeck granules (tennis rackets on EM)