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Questions and Answers
What are Pappenheimer bodies associated with in a red blood cell smear?
What are Pappenheimer bodies associated with in a red blood cell smear?
- Presence of leukocytes
- Presence of bilirubin
- Presence of hemoglobin
- Presence of nonheme iron (correct)
How are Pappenheimer bodies and siderotic granules differentiated?
How are Pappenheimer bodies and siderotic granules differentiated?
- By the type of stain used (correct)
- By the presence of a nucleus
- By their location within the cell
- By the size of the inclusions
What is the confirmatory test for determining the presence of Pappenheimer bodies?
What is the confirmatory test for determining the presence of Pappenheimer bodies?
- Supravital stain
- Prussian blue stain (correct)
- Gram stain
- Wright stain
Which condition often leads to the formation of Pappenheimer bodies?
Which condition often leads to the formation of Pappenheimer bodies?
Which of the following best describes where Pappenheimer bodies typically appear in red blood cells?
Which of the following best describes where Pappenheimer bodies typically appear in red blood cells?
What is the primary difference between Pappenheimer bodies and siderotic granules?
What is the primary difference between Pappenheimer bodies and siderotic granules?
What is indicated by nonheme iron inclusions found in red blood cells?
What is indicated by nonheme iron inclusions found in red blood cells?
What type of staining technique would reveal the presence of siderotic granules?
What type of staining technique would reveal the presence of siderotic granules?
What are Heinz bodies primarily composed of?
What are Heinz bodies primarily composed of?
Which feature is characteristic of sickle cells?
Which feature is characteristic of sickle cells?
What is the primary difference between siderocytes and Pappenheimer bodies?
What is the primary difference between siderocytes and Pappenheimer bodies?
How are Howell-Jolly bodies formed?
How are Howell-Jolly bodies formed?
Which of the following stains are used to identify Heinz bodies?
Which of the following stains are used to identify Heinz bodies?
What appearance do target cells exhibit?
What appearance do target cells exhibit?
What type of granules are present in siderocytes?
What type of granules are present in siderocytes?
What is a common cause of basophilic stippling?
What is a common cause of basophilic stippling?
What staining method is responsible for identifying the iron portion of granules?
What staining method is responsible for identifying the iron portion of granules?
What term is used for cells containing siderotic granules?
What term is used for cells containing siderotic granules?
How are sideroblasts characterized?
How are sideroblasts characterized?
In which condition would one typically observe siderocytes?
In which condition would one typically observe siderocytes?
What is the primary difference between Pappenheimer bodies and siderotic granules?
What is the primary difference between Pappenheimer bodies and siderotic granules?
What type of anemia is commonly associated with the presence of sideroblasts?
What type of anemia is commonly associated with the presence of sideroblasts?
What technique is used for general visualization of Pappenheimer bodies?
What technique is used for general visualization of Pappenheimer bodies?
Which of the following disorders may not typically show siderocytes?
Which of the following disorders may not typically show siderocytes?
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Study Notes
Pappenheimer Bodies and Siderotic Granules
- Pappenheimer bodies are small, irregular magenta inclusions found on the periphery of red blood cells
- They appear in clusters and are presumptive evidence of iron in the red blood cell
- Prussian blue stain is the confirmatory test for iron in these inclusions
- Pappenheimer bodies and siderotic granules are the same inclusions, containing nonheme iron from excess available iron in the body
- The name used depends on the stain used
- Pappenheimer bodies are seen when using Wright's stain
- Siderotic granules are seen when using Prussian blue or other iron stains
- Romanowsky stains visualize the protein matrix of the inclusion
- Prussian Blue stain visualizes the iron portion of the the inclusion
Siderocytes
- Once the presence of siderotic granules has been confirmed by an iron stain, the cell is termed a siderocyte
- Sideroblasts are siderocytes containing a nucleus and are commonly seen in sideroblastic anemias
- Ringed sideroblasts contain numerous siderotic granules within the mitochondria that form a ring around at least one-third of the nucleus
- Siderocytes are seen in conditions with iron overloading such as hemochromatosis
- Sickle cell anemia and thalassemia are hemoglobinopathies in which siderocytes appear
- Patients following splenectomy may have siderocytes
Erythrocyte Inclusions
Basophilic Stippling
- Fine or coarse blue-black granules in the red blood cell
- Granules are evenly distributed and uniform in size
- Irregularly aggregates/clumps of basophilic RNA/clumped ribosomes
- Sometimes termed punctate basophilia
Howell-Jolly Bodies
- Usually fragments of the nucleus (DNA)
- Formed from separated chromosomes during abnormal cell division or from small nuclear fragments produced by nuclear fragmentation (karyorrhexis)
Cabot Rings
- Red-violet oval rings or figures eight-shaped structures in the red blood cell
- May be nuclear remnants or part of the mitotic spindle
Heinz Bodies
- Denatured hemoglobin, single or multiple, appearing as refractile, round, oval or irregular structures
- Not stained by Romanowsky stains
- Only stained with supra-vital stains
Siderocytes
- Contain siderotic granules, iron-containing structures
- Stain bright blue with Perls’ Prussian blue (PBB) reactions
Pappenheimer bodies
- Faint blue iron granules or rods, found when stained with Wright-Giesma stained smears
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