RBC Morphology & Production Flashcards
Progression of RBC production
1) HSC (stem cell)
2) Common Myeloid Progenitor
3) Megakaryocyte - Erythrocyte progenitor
4) Pronormoblast
5) Basophilic Normoblast
6) Polychromatic Normoblast
7) Orthochromic Normoblast
8) Polychromatic Erythrocyte
9) Erythrocyte
Which RBC precursors are in the mitotic pool?
Pronormoblast to Orthochromoic Normoblast
Pronormoblast
Nucleus is round to oval
1 - 2 Nucleoli
Chromatin is fine
Cytoplasm is dark blue, may have Golgi apparatus easily seen
N:C ratio 8:1
Bone Marrow - if in Peripheral blood - send to pathology
Basophilic Normoblast
Nucleus is round to slightly oval
0 - 1 Nucleoli
Chromatin is slightly condensed
Cytoplasm is dark blue
N:C ratio 6:1
Bone Marrow - not typical in peripheral blood
Polychromatic Normoblast
Nucleus is round
No Nucleoli
Chromatin is quite condensed
Cytoplasm is grey-blue
N:C ratio 4:1
Bone Marrow - not typical in peripheral blood
Orthochromic Normoblast aka nRBC
Nucleus is round
0 Nucleoli
Chromatin is fully condensed
Cytoplasm is more pink or salmon
N:C ratio 0.5:1
Bone Marrow - but may be seen in peripheral blood
Will need calculation if present in >5 cells/100 WBC
Polychromatic Erythrocyte aka Reticulocytes with supravital stain
Nucleus is absent
0 Nucleoli
No Chromatin
Cytoplasm is slightly more blue/purple
Mostly Bone Marrow but can be seen in peripheral blood
Erythrocyte aka RBC
Normochromic
Cytoplasm is salmon with central pallor of about 1/3 the diameter of cell
Predominant cell type in normal blood
Hypochromic
Central paollor zone must be greater than 1/3 of the diameter
MCHC will be decreased
Dimorphic RBC
Increases RDW
Seen with transfusions and sideroblastic anemia
Acanthocyte or Spur Cell
Multiple irregularly spaced projections often with drumstick ends
Crenated cells have less of a spike appearance
Does not effect MCV or MCHC
Schistocyte or Fragments (can also be Helmet cells)
RBCs are ripped apart
Decreases MCV
Echinocyte or Burr Cell
RBC with short, evenly spaced projections usually with central pallor
Looks like a spur on a boot
Does not effect MCV or MCHC
Spherocyte
Round with no central pallor
Darker stain than other RBCs
Increases MCHC
Decreased Surface to Volume ratio
Codocyte or Target Cell
Red to salmon
Bull’s eye appearance
Does not effect MCV or MCHC
Abnormal cholesterol ratio in membrane
Drepanocyte or Sickle Cell
Dark red to salmon
Lacks central pallor
Elongated with point on at least one or both ends
Decrease in MCH
Deoxygenated Hgb
Hemoglobin CC Crystals
Dark red
Hexagonal
Hemoglobin SC Crystal
Dark red
1-2 finger-like projections (resembles mitten or Washington Monument)
Elliptocyte
Cigar-shaped RBC
Ovalocyte
Egg shaped RBC
Dacryocyte or Teardrop
Teardrop or Pear, may have one blunt projection
Only call if several points are going in many different directions
Does not effect MCV or MCHC
Associated with extramedullary hematopoiesis
Stomatocyte
Slit-like area of central pallor
Similar to mouth or stoma
Does not effect MCV or MCHC
Rouleaux
RBC arranged in rows like stacks of coins
Increased proteins in patients
Disperse with saline
Autoaggluntinin
RBCs clumping
May be counted as one RBC on CBC - lowers RBC count
If cold agglutinin - false agglutination - warm and rerun sample
Bite Cell
Spleen removed a portion of the RBC
Blister Cell
Previous to Bite cell - Hgb is precipitating out of cell and forming a blister (transparent area on side of RBC)
Howell Jolly Bodies
DNA precipitation (usually one)
Wright stain, Supravital
Basophilic stippling
RNA precipitation
Wright stain, Supravital
Pappenheimer Bodies or Siderotic Granules
Iron precipitation
Wright stain, Supravital, or Prussian Blue
Cabbot ring
Loop, ring, or figure eight
May also look at beads on a string
Remnants of mitotic spindle
Wright stain, Supravital
Malaria ring
Reticulocyte
RNA
Supravital
Heinz bodies
Unstable Hgb
Supravital
Bite cell
Hemoglobin H
Supravital stain
Polychromic RBC
Reticulocyte
Increases MCV
