Red Blood Cell Inclusions Quiz

Study Notes

Bite Cells (Degmacytes): Demonstrate a semicircular defect, resembling a bite mark. Associated with glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Biscuit Cells: Folded red blood cells. Associated with hemoglobin SC disease.
Bronze Elliptocytes: Have bipolar or central distribution of hemoglobin. Associated with sickle cell anemia.
Semilunar Bodies: As large as leukocytes, pale-pink staining ghosts of red blood cells remaining after membrane release. Common in conditions causing hemolysis.
Basophilic Stippling (Punctate Basophilia): Irregular, dark blue to purple granules evenly distributed within red blood cells. Associated with aggregated RNA. Conditions include lead poisoning, arsenic poisoning, and pyrimidine-5'-nucleotidase deficiency. Also associated with anemias with impaired hemoglobin synthesis (thalassemia), refractory anemia, and alcoholism.
Siderotic Granules (Pappenheimer bodies): Dark blue, irregular granules in red blood cells. Intra-erythrocytic collections of iron, visualized with Prussian blue staining. Associated with impaired hemoglobin synthesis.
Basophilic Stippling: Two forms:
- Fine stippling: Often seen with polychromatophilia, plumbism, and megaloblastic anemia.
- Coarse stippling: Related to impaired hemoglobin synthesis, plumbism, and megaloblastic anemia.

Sideroblastic Anemias: Characterized by a dimorphic peripheral blood picture (presence of both normocytic and hypochromic red blood cells).
Thalassemia: A condition associated with presence of dimorphic blood cells (presence of both normochromic and hypochromic red blood cells)
Hemochromatosis/Hemosiderosis: Associated with iron overload.