Peripheral Blood Films Flashcards
Description and Underlying Conditions:
Acanthocytes
Spur/Spike like cells
RBCs show many spicules (spiked cell membrane)
Abetalipoproteinaemia, liver disease, hyposplenism
Description and Underlying Conditions:
Basophilic RBC stippling
Erythrocytes have small dots at the periphery (visualization of ribosomes). Can be normal, but normally due to accelerated erythropoiesis or defective Hb synthesis:
Lead poisoning, megaloblastic anaemia, myelodysplasia, liver disease, haemoglobinopathy
Description and Underlying Conditions: Burr Cells (Echinocytes)
(N.B. ‘Echinos’ means hedgehog in Greek!)
Irregularly shaped cells: small, evenly spaced thorny projections of the cell membrane.
Uraemia, GI bleeding, stomach carcinoma
Description and Underlying Conditions:
Heinz Bodies
Inclusions within RBCs of denatured Hb
G6PD, Chronic liver disease, Alpha Thalassaemia
Can also be seen in hyposplenism/asplenia
(Best seen on New Methylene Blue stain)
Description and Underlying Conditions:
Howell-Jolly Bodies
Basophilic (purple spot) nuclear remnants in RBCs.
Hyposplenism (Sickle cell disease, coeliac disease, congenital, IBD), Megaloblastic anaemia, hereditary spherocytosis.
N.b During maturation, erythrocytes normally expel their nuclei, this is what is seen if a little bit stays
Description and Underlying Conditions:
Leucoerythroblastic (myelophthisic) anaemia
Nucleated RBCs and primitive WBC into peripheral blood
Marrow infiltration i.e. myelofibrosis, malignancy
Description and Underlying Conditions:
Pelger Huet Cells
Hyposegmented neutrophil
Congenital: lamin B receptor mutation
Acquired: myelogenoous leukaemia and myeldysplastic syndromes
Description and Underlying Conditions:
Polychromasia
RBCs of multiple colours (particularly grey-blue) due to varying amounts of Hb
Premature/inappropriate release from BM.
All polychromatophilic cells are reticulocytes, but not all reticulocytes are polychromatophilic!
Description and Underlying Conditions:
Reticulocytes
Immature RBCs (mesh like network of ribosomal RNA becomes visible with certain stains i.e New Methylene blue)
Increased Reticulocytes: Haemolytic anaemias
Decreased Reticulocytes: Aplastic anaemia, chemo
Description and Underlying Conditions:
Right Shift
Hypermature white cells - hypersegmented polymorphs (over 5 lobes to nucleus)
Megaloblastic anaemia, uraemia, liver disease
Description and Underlying Conditions:
Rouleaux formation
Red cells stacked on each other
Chronic inflammation, paraproteinaemia, myeloma
Description and Underlying Conditions:
Schistocytes
Fragmented parts of RBCs - typically irregularly shaped, jagged and asymmetrical
Microangiopathic anaemia eg. DIC, haemolytic uraemic syndrome, TTP, pre-eclampsia
Description and Underlying Conditions:
Spherocytes
Sphere shaped RBCs
Hereditary spherocytosis, Autoimmune Haemolytic Anaemia
Description and Underlying Conditions:
Stomatocytes
Central Pallor is straight or curved rod like shape. RBCs appear as smiling faces or fish mouths
Hereditary stomatocytosis, high alcohol intake, liver disease
Description and Underlying Conditions: Target Cells (codocyte)
Bulls-eye appearance in central pallor
Liver disease, hyposplenism, thalassaemia, IDA
