red cell inclusions

Question 1

describe Pappenheimer bodies: composition, what stains can make them visible, and what a cell containing them is called

Answer 1

ferritin (storage iron) precipitates; seen on Wright’s stain bc they aggregate with mitochondria (stainable with Wright’s); On Prussian blue stain you are actually seeing the iron. These cells are siderocytes

Question 2

what is the term for RBC inclusions consisting of aggregated ribosomal RNA and proteins?

Answer 2

Basophilic stippling

Question 3

How can staining be used to diff btw Pappenheimer bods and basophilic stippling?

Answer 3

The basophilic stippling won’t be visible with Prussian blue

Question 4

what are Heinz bodies and in what conditions may you see them?

Answer 4

Precipitated hemoglobin (H for H!!!) seen in disorders of hemoglobin such as Hemoglobin H disease (beta thalassemia intermedia, only one functional gene) or G6PD deficiency which increases oxidative damage of hemoglobin and causes the globin chains to denature and aggregate; they also increase after splenectomy bc they aren’t removed. Seen only on supravital stain!!!! Not Wright’s

Question 5

what are Howell-Jolly bodies and when may you see them?

Answer 5

these are nuclear remnants (DNA) seen on Wright’s stain (as opposed to Heinz bodies); associated with post-splenectomy as well and in anything causing macrocytosis such as pernicious anemia