RBC anomalies Flashcards by Ma. Carmina Ruth Romero

increased number of red cells with variation in size

Anisocytosis

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normal RBCs diameter

7-8um

80-100 fL

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-associated with impaired DNA synthesis

Macrocytes

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associated with defective hemoglobin formation

microcytes

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Four ways to detect anisocytosis:

1) nucleus of a lymphocyte
2) MCV value
3) RDW value
4) RBC histogram

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a calculated index (from the RBC histogram) given by hematology analyzers to
help identify anisocytosis and provide information about its degree

red cell distribution width (RDW)

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DERIVATION OF RDW-CV

A - Beckman Coulter, Inc

B - Sysmex Corporation

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RDW ref. range for newborns

14.2% to 19.9%

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visual display of cell size in RBC histogram

X-axis

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cell frequency or the number of cells in RBC histogram

Y-axis

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two parameters calculated from RBC histogram

: MCV and RDW

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shift to the right.

RBCs are macrocytic,

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shift to the left

RBCs are microcytic

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bimodal

two populations of RBCs in the sample

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wider or flattened curve on a histogram indicates

more variation in the size of the cells

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General term for a variation in the normal coloratio

anisochromia

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occurrence of hypochromic cells and normochromic cells in the same blood smear

anisochromia

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hypocrhomic cells

central pallor 1/3 of diameter (microcytic)

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grading of hypochromia 4+

thin rim of hemoglobin

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Pesary cell/ghost cell

Anulocyte

-thin rim of Hgb

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RBCs that lack central pallor even though they lie in a desirable area for evaluation

Hyperchromic cells

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basically the only disease in which the MCHC is high

Hereditary Spherocytosis

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symptomatic HS 3 clinical manifestation

1) Splenomegaly
2) Anemia
3) Jaundice

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HS MCHC value

35-38 g/dL

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more sensitive alternative test for confirmation of HS.

EMA binding test

larger than normal red cells with bluish tinge (Wright’s stain)

Polychromatophilic erythrocytes

bluish tinge in Polychromatophilic erythrocytes

residual RNA

increased number of red cells with variation in SHAPE

Poikilocytosis

Almost spherical in shape | Lacks the central pallor

SPHEROCYTE

STOMATOCYTE aka

Mouth cell

Elongated RBCs with a slit-like | central pallo

STOMATOCYTE

-most common form of stomatocytosis

Dehydrated hereditary | stomatocytosi

appears to have puddled at one end

Dehydrated hereditary | stomatocytosi

ACANTHOCYTE aka

thorn cell/spur cell

RBCs with irregularly | spiculated surface

ACANTHOCYTE

Abetalipoproteinemia aka

Bassen-Kornzweig syndrome | & Hereditary acanthocytosis

characterized by defective apo B synthesis

Abetalipoproteinemia

what are NOT | found in plasma in Abetalipoproteinemia

VLDL, LDL, and | chylomicron:

McLeaod syndrome(kell bld group)

ACANTHOCYTE

BURR CELL aka

Echinocyte

RBCs with | regularly spiculated surface

BURR CELL

BURR CELL associated with

Uremia | & Pyruvate kinase deficiency

hereditary leptocytosis

Elliptocyte

Elliptical (cigar-shaped) RBC

Elliptocyte

DACRYOCYTE aka

teardrop/pear-shaped

Primary Myelofibrosis (PMF)

dacryocytes

Fragmented RBC

schistocytes/schizocytes

DIC tests

D-dimer test | PF 1+2

DIC related conditions

" TOMASA " ``` Tissue trauma Obstetric complications Mucus-secreting tumors Acute infections Snake bites Acute promyelocytic leukemia ```

Drepanocyte aka

Sickle cell/ meniscocyte

sickle/crescentshaped

Drepanocyte

Two forms of drepanocyte

1) irreversible sickle cells (ISC) | 2) Oat-shaped cell

no capacity to return to normal shape

irreversible sickle cells (ISC)

once oxygenated can go back to original form

oat cell

RBCs which show a centrally stained area with a thin outer rim of hemoglobin

LEPTOCYTE

LEPTOCYTE aka

codocyte, platycyte, Greek helmet cell, mexican hat cell, Bull's eye cell, target cell

leptocyte associated with

liver disease, certain hemoglobinopathies, Thalassemia LCAT deficiency

BITE CELL aka

Degmacyte

Glucose-6-Phosphate Dehydrogenase (G-6-PD) deficiency poikilocyte

BITE CELL

Demonstrate a semicircular defect in their edge (resembles a bite mark)

BITE CELL

Folded RBCs

BISCUIT CELL

Hemoglobin SC disease

BISCUIT CELL

BRONZE ELLIPTOCYTE associated with

Sickle cell anemia

Bipolar or central distribution of | hemoglobin

BRONZE ELLIPTOCYTE

-As large as leukocytes -Pale-pink staining ghost of the red cell

SEMILUNAR BODY

associated with malaria and overt hemolysis

semilunar body

punctate basophilia

basophilic stippling

aggregated RNA

basophilic stippling

basophilic stippling associated with

- Lead poisoning (plumbism) | - megaloblastic anemia

2 forms of basophilic stippling

1) fine stippling - polychromatophilia | 2) coarse stippling -

iron stains

siderotic granules

NMB, Wright stain

Pappenheimer bodies

SIDEROTIC GRANULES

dimorphic peripheral blood picture

Sideroblastic anemia

Remnants of nuclear chroma | tin (DNA)

HOWELL-JOLLY BODIES

HOWELL-JOLLY BODIES associated

- Megaloblastic anemias - After splenectomy - Thalassemia

histochem staining reaction for DNA

Feulgen reaction (+)

THREADLIKE/ MITOTIC SPINDLES

CABOT RINGS

Denatured and | precipitated hemoglobin

HEINZ BODIES

-Glucose-6-Phosphate Dehydrogenase (G-6-PD) deficiency inclusion body

HEINZ BODIES

supravital stains for HEINZ BODIES

NMB BCB Crystal violet methyl violet

eccentrically along the inner RBC membrane, large, round, blue to purple materials)

HEINZ BODIES

Precipitated Hb H

Hb H inclusion bodies

Hgb H disease is associated with

Alpha thalassemia

Appearance of RBCs with Hb H Bodies:

pitted golf balls

graded as : 1 + = 1 to 5 per field 2 + = 6 to 10 per field 3 + = greater than 10 per field

``` Polychromatophilia Helmet cells (helmet-shaped schistocytes) Dacryocytes (teardrop cells) Acanthocytes (thorn or spur cells) Schistocytes (fragmented RBCs) Spherocytes ```

1 + = 3 to 10 per field 2 + = 11 to 20 per field 3 + = greater than 20 per field

``` Poikilocytosis Ovalocytes Elliptocytes Burr cells Bizarre-shaped RBC Target cells (codocytes/leptocytes/bull’s eye cell/ Mexican hat cells/Greek helmet cells/platycytes) Stomatocytes (mouth cells) ```

pseudoagglutination aka

Rouleaux

Caused by a serum protein abnormality

Rouleaux

1 + IN ROULEAUX

= aggregates of 3 to 4 RBCs

2 + IN ROULEAUX

= aggregates of 5 to 10 RBCs

3 + IN ROULEAUX

= many aggregates with | only a few free RBCs

Graded as POSITIVE only

Sickle cells Basophilic stippling Pappenheimer bodies Howell-Jolly bodies