Pathologic RBC Forms

Question 1

acanthocytes

Answer 1

spur cells

Question 2

acanthocytes associated pathology

Answer 2

liver disease, abetalipoproteinemia (states of cholesterol dysregulation)

Question 3

acanthocytes notes

Answer 3

acantho = spiny

Question 4

basophilic stippling associated pathology

Answer 4

sideroblastic anemia (lead poisoning, myelodysplastic syndromes), thalassemias

Question 5

basophilic stippling notes

Answer 5

seen primarily in peripheral smear, vs ringed sideroblasts seen in bone marrow
aggregation of residual ribosomes

Question 6

dacrocytes

Answer 6

teardrop cells

Question 7

dacrocytes associated pathology

Answer 7

bone marrow infiltration (e.g. myelofibrosis), thalassemias

Question 8

dacrocytes notes

Answer 8

RBC ‘sheds a tear’ because it’s mechanically squeezed out of its home in the bone marrow

Question 9

degmacytes

Answer 9

‘bite cells’

Question 10

degmacytes associated pathology

Answer 10

G6PD deficiency

Question 11

echinocytes

Answer 11

burr cells

Question 12

echinocytes associated pathology

Answer 12

end-stage renal disease, liver disease, pyruvate kinase deficiency

Question 13

echinocytes notes

Answer 13

different from acanthocyte; tis projections are more uniform and smaller

Question 14

elliptocytes associated pathology

Answer 14

hereditary elliptocytosis, usually asymptomatic; caused by mutation in genes encoding RBC membrane proteins (e.g. spectrin)

Question 15

macro-ovalocytes associated pathology

Answer 15

megaloblastic anemia (also hyperhsegmented PMNs)

Question 16

ringed sideroblasts associated pathology

Answer 16

sideroblastic anemia

excess iron in mitochondria

Question 17

ringed sideroblasts notes

Answer 17

seen in bone marrow with special staining (Prussian blue) vs. basophilic stippling in peripheral smear

Question 18

schistocytes associated pathology

Answer 18

microangiopathic hemolytic anemias, including DIC, TTP/HUS, HELLP syndrome, mechanical hemolysis (heart valve prosthesis)

Question 19

schistocytes notes

Answer 19

fragmented RBCs (helmet cells)

Question 20

sickle cells associated pathology

Answer 20

sickle cell anemia

Question 21

sickle cell notes

Answer 21

sickling occurs with dehydration, deoxygenation, and at high altitude

Question 22

spherocytes associated pathology

Answer 22

hereditary spherocytosis, drug- and infection-induced hemolytic anemia

Question 23

spherocytes notes

Answer 23

small, spherical cells without central pallor

Question 24

target cells associated pathology

Answer 24

HbC disease, Asplenia, Liver disease, Thalassemia

Question 25

target cells notes

Answer 25

HALT, said the hunter to his Target

Question 26

Heinz bodies associated pathology

Answer 26

seen in G6PD deficiency

Question 27

Heinz bodies notes

Answer 27

oxidation of Hb-SH groups to -S–S- -> Hb precipitation (Heinz bodies), with subsequent phagocytic damage to RBC membrane -> bite cells

Question 28

Howell-Jolly bodies associated pathology

Answer 28

seen in patients with functional hyposplenia or asplenia

Question 29

Howell-Jolly bodies notes

Answer 29

basophilic nuclear remnants found in RBCs

Howell-Jolly bodies are normally removed from RBCs by splenic macrophages