Pathological RBCs

Question 1

Bite Cells

Answer 1

semi-circle missing from edge due to oxidative damage (oxidant drug or G6PD def)

Question 2

Burr Cells

Answer 2

“echinocytes”

short, even serrations

-chronic kidney disease, liver disease, pyruvate kinase def or artifact

Question 3

Spurr Cells

Answer 3

“Acanthocytes”

spicules at diff angle

-artifact, end stage liver disease or abetalipoproteinemia

Question 4

Hypochromic

Answer 4

• More central pallor (>1/3 cell)

- Anything w/ reduced Hb (iron deficiency, thalassemia, sideroblastic anemia)

Question 5

Macrocytes v Microcytes

Answer 5

• Macrocyte - larger cell; reticulocyte or abnormal DNA damage but cyto expands
• Microcyte - smaller cell; reduced Hb synthesis (thal, iron def)

Question 6

Schistocyte

Answer 6

fragmented w/ no central pallor and 2-3 pointed ends

from mechanical disruption - prosthetic valve, microangiopathic anemia (DIC, TPP)

Question 7

Spherocyte

Answer 7

dense sphere w/o central pallor from dec membrane redundancy

immune hemolytic anemia, hereditary spherocytosis, transfusion, artifact, drug-induced

Question 8

Target Cells

Answer 8

dark center w/in central pallor from inc redundancy of membrane

HALT at target - HbC disease, Asplenia, Liver disease, Thalassemia

Question 9

Teardrop Cells

Answer 9

“Dacrocyte”

drop shape from mechanical distortion (bone marrow or splenic fibrosis or bone marrow infiltration)

RBCs crying b/c displaced from home (marrow) by infiltrate

Question 10

Basophilic Stippling

Answer 10

Aggregation of residual ribosomes

Lead poisoning, sideroblastic anemia, myelodysplastic syndromes

Question 11

Howell Jolly Bodies

Answer 11

Basophilic nuclear remnant normally removed by splenic macrophages

Remains if asplenia, hyposplenia

Question 12

Heinz Bodies

Answer 12

In G6PD deficiency

Oxidation of Hb-SH groups –> S-S –> Hb precipitates (body)