Peripheral Blood Morphology Flashcards
What does peripheral blood smear observe?
feathered edge
What is the next step after peripheral blood smearing?
stain with Wright Giemsa
Characteristics of Normal Peripheral Blood
- RBC size = lymphocyte nucleus size
- RBC central pallor is 1/3 of total RBC diameter
- White cells and platelets are present
Red cells which vary widely in size are referred as
anisocytosis
Measured by RDW
Red cells that are small
microcytosis
Measured by MCV or compare with lymphocyte as a visual reference
What are the differential diagnosis of microcytosis?
- Iron deficiency
- thalassemias
- lead poisoning
- sideroblastic anemia
- anemia of chronic disease (usually normocytic)
- hemoglobin C disease and trait
Red cells that are large
Macrocytosis
Measured by MCV or compare with lymphocyte as a visual reference
What are the differential diagnosis of macrocytosis?
- B12/folate deficiency
- liver disease
- thyroid disease
- chemotherapy
- anti-retrovirals
- aplastic anemia (usually normocytic)
- MDS (usually normocytic)
- elevated reticulocyte count
Refers to red cells that have too little hemoglobin.
Hypochromasia
Measured by MCH
Refers to red cells that have more of a bluish tinge and are probably reticulocytes
Polychromasia
refers to red cells that vary widely in shape
Poikilocytosis
These cells look like bulls-eyes and are associated with: Liver disease Thalassemias Hemoglobin C After splenectomy
Target cells
These cells have a loss of central pallor and can be seen in diseases such as: Hereditary spherocytosis and Autoimmune hemolysis
Spherocytes
Red cell fragments with sharp edges that are a hallmark of Microangiopathic Hemolytic Anemia (MAHA)
Schistocytes
These cells have bites taken out of them and are a hallmark of Heinz Body hemolytic anemia due to 2 conditions (1. G6PD deficiency-most common; 2. Hemoglobin H disease)
Bite Cells
Cells that are seen in sickle cell anemia.
Sickle cells
These cells have small, regular projections and are seen in renal disease
Echinocytes, or burr cells,
These cells have have large, irregular projections, and are seen in liver disease.
Acanthocytes, or spur cells
These cells are seen in myelophthisic processes and can be seen in: Myelofibrosis Tumor metastatic to marrow Granulomatous diseases Leukemias and lymphomas Sometimes in massive splenomegaly
Teardrop cells
Diseases of marrow infiltration are known as?
Myelophthisic processes
These cells are peripheral, small, round, purple inclusions within red cells that represent nuclear remnants usually seen after splenectomy, or in cases of splenic hypofunction
Howell-Jolly Bodies
Linear arrangements of red cells typically described as “piles of coins on a plate”
Rouleaux
These RBC are typically seen in disorders with increased levels of immunoglobulin, such as Multiple Myeloma, Waldenstrom’s macroglobulinemia, and Severe hypo-albuminemia due to a change in the charge of the RBC
Rouleaux
Occurs when the red cells are coated with IgM.
agglutination
Not orderly and linear as Rouleaux
Patients with this disease have a blood smear that has hypo chromic cells, microcytic cells and an increased number of platelets.
Iron Deficiency Anemia
In this condition, Red cells are macrocytic and hypersegmented neutrophils can be seen. It usually results from a deficiency in Vitamin B12 or folate
Megaloblastic Anemia
A patient whose blood smear shows Polychromasia and Microspherocytes most likely has which condition?
Autoimmune Hemolytic Anemia (AIHA)
A patient whose blood smear shows schistocytes most likely has which condition?
Microangiopathic Hemolytic Anemia (MAHA)
