Summary

This document is a lesson about red blood cell morphology, covering different shapes, sizes, and variations related to red blood cell morphology. It includes detailed information on various types of red blood cell abnormalities and disorders.

Full Transcript

Hema I L-III [RBC Morphology] 2. Elliptocytes - Cigar~Egg shaped Caused by RBC membrane Cell Morphology classifications deficiency; Spectrin Size (Anisocytosis) Hereditary...

Hema I L-III [RBC Morphology] 2. Elliptocytes - Cigar~Egg shaped Caused by RBC membrane Cell Morphology classifications deficiency; Spectrin Size (Anisocytosis) Hereditary Elliptocytosis, Shape (Poikilocytosis) Thalassemia Major, Hgb Variation (Anisochromia) Megaloblastic Anemia Inclusion Bodies Distribution Alteration 3. Codocytes - “Leptocytes, Target cell, Bull’s eye appearance, Mexican Hat A. Size - Anisocytosis cell, Greek helmet cells” To determine, PBS, RBC indices, RDW Centrally large + thin outer MCV - 80~100 Normal Value stain 100, macrocytic EXCESS Surface: Volume 1. Microcytic - decreased Hgb Ratio synthesis leading to mitochondrial Liver diseases, abnormality Hemoglobinopathies, Low in Iron Thalassemia ATIS - Anemia of Chronic Disease 4. Echinocytes - SPICULES (Regular) Thalassemia “Crenated” cells, Sea Iron Deficiency Anemia Urchin cell, Burr cell Sideroblastic Anemia > Artificially caused in PBS when drying 2. Macrocytic - defect in nuclear Caused by changes within maturation of RBC the osmotic pressure within = Megalobastic Anemia the cell = Vit B12, Folate deficiencies Liver disease, Uremia (high Urea; waste), Pyruvate 3. Normocytic - Normal size, kinase deficiency “Discocytes” 7.2 avg diameter, 2 avg 5. Drepanocytes - “Sickle cell” thickness - Elongated ends Biconcave, round, ⅓ central - Polymerization of Hgb S pallor, Salmon Pink color - > Caused by cell membrane alteration B. Shape - Poikilocytosis - Decreased oxygen level, 1. Spherocytes - No central pallor Blood ph: Acidic Caused by RBC membrane deficiency; Spectrin 6. Schistocyte - Fragmented RBCs DECREASED Surface: Disseminated Intravascular Volume Ratio Coagulation Hereditary Spherocytosis, Microangiopathic Hemolytic G6PD Deficiency Anemia Uremia D. Inclusion Bodies 7. Dacryocyte - “Teardrop cell” - Pear-shaped 1. Basophilic stippling - fine/ coarse Primary Myelofibrosis granules in RBC Thalassemia -> RNA remnants Megaloblastic anemia -> Increased heme synthesis “Blueberry bagel” appearance 8. Stomatocytes - “Mouth Cells” Lead poisoning, Severe > Slit-like central pallor anemia Na+, K+ imbalance Overhydrated: increased Na [ Wright & Supravital stain ] inside the cell Dehydrated: decreased K in 2. Cabot rings - “ 8 / loop-shaped” the cell > from mitotic spindle remnants Rh-null (negative), > red/reddish purple Alcoholism, Severe liver Pernicious anemia, Lead diseases poisoning, Abnormal erythropoiesis, Histone 9. Acanthocyte - SPICULES (Uneven) biosynthesis “Thorny cell, Spur cell” - Lacks central pallor [ Wright & Supravital stain ] - INCREASED cholesterol - McLeod Syndrome 3. Heinz Bodies - denatured & - Abetalipoproteinemia precipitated Hgb - Post splenectomy > Pitted golf ball appearance G6PD deficiency, C. Hgb Variation (Color) Anisochromia Hemoglobinopathy, > To determine: MCH, MCHC Beta-thalassemia major > ⅓ central pallor = smaller: increased Hgb, larger: decreased Hgb [ Supravital stain ] Hyperchromia, Normochromia, Hypochromia 4. Howell-Jolly Bodies - DNA remnants > Accelerated/abnormal 1. Hypochromic - dominant pale, bigger erythropoiesis than 1/3cp - microcytic Hemolytic anemia, Fe Deficiency Megaloblastic anemia, Thalassemia Splenectomy Sideroblastic [ Wright & Supravital stain ] 2. Hyperchromic - Deeply stained, Abnormal thickness 5. Pappenheimer bodies - Siderotic Macrocytosis granules Spherocytosis > Aggregates of mitochondria, Megaloblastic ribosomes, & iron [ Prussian blue / Wright Stain ] 6. Crystal > Hb C Hb H -> Polymerization from Hb A 7. Parasitic inclusions >Plasmodium falciparum - Malignant Tertian (normal RBC) Maurer’s dots >Plasmodium ovale - Benign Tertian (enlarged young RBC) Schuffner’s dots (Jame’s dots) >Plasmodium vivax - Benign Tertian (enlarged RBC) Schuffner’s dots >Plasmodium malariae - Quartan malaria (normal RBC) Zeimann’s dots >Plasmodium knowlesi - Stinton & Mulligan’s dots >Babesia microti - (normal RBC) Maltase cross “tetrad-form” > Nucleated RBC - Orthochromatic/metarubricyte (RETICS) Accelerated erythropoiesis, Myeloproliferative disorder E. Alteration in RBC Distribution 1. Rouleaux formation - stack of coins >High protein content 2. Agglutination - Clumps/ no pattern / irregular

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