Pathological RBCs

Question 1

Acanthocyte

Answer 1

Aka spur cell

Liver disease and abetalipoproteinemia

Question 2

Basophilic Stippling

Answer 2

Lead toxicity, sideroblastic anemia and myelodysplastic syndrome

Represents aggregation of residual ribosomes

Question 3

Dacrocyte

Answer 3

Aka tear drop cell

Bone marrow infiltration like myelofibrosis

RBCs shed a tear because squeezed out of home in bone marrow

Question 4

Degmacyte

Answer 4

Aka bite cell

G6PD deficiency

Question 5

Echinocyte

Answer 5

Aka burr cell

End stage renal disease or liver disease or pyruvate kinase deficiency

Question 6

Ellipocyte

Answer 6

Hereditary ellipocytosis caused by mutation in RBC membrane protein genes like spectrin

Question 7

Macro-ovalocyte

Answer 7

Megaloblastic anemia

Also see hyper segmented PMNs

Question 8

Ringed sideroblast

Answer 8

Sideroblastic anemia causing excess iron in mitochondria

Seen in bone marrow NOT smear of periphery

Question 9

Schistocyte

Answer 9

Microangiopathic hemolytic anemia like DIC, HUS, TTP, HELLP, or mechanical lysis from prosthetic valve

Fragmented RBCs like helmet cells

Question 10

Sickle Cell

Answer 10

Occurs in dehydration, deoxygenation and high altitude

Question 11

Spherocyte

Answer 11

Hereditary spherocytosis

Or drug/ infection induced hemolytic anemia

Question 12

Target Cells

Answer 12

HALT

HbC

Asplenia

Liver disease

Thalassemia

Question 13

Heinz bodies

Answer 13

Seen in G6PD deficiency

Oxidation of Hb-SH groups to S-S leading to Hb precipitation and subsequent phagocytic damage to red cell membrane (bite cell)

Question 14

Howell- Jolly Bodies

Answer 14

In functional hyposplenia or asplenia

Basophilic nuclear remnants normally removed by spleen remain