MT303A LEC - (Week 3) Red Blood Cell Morphology PDF

MT303A LEC WEEK 3: RED BLOOD CELL MORPHOLOGY (TRANSCRIPT) BSMLS VARIATION FROM NORMAL RED BLOOD CELL II. Elliptocyte...

MT303A LEC WEEK 3: RED BLOOD CELL MORPHOLOGY (TRANSCRIPT) BSMLS VARIATION FROM NORMAL RED BLOOD CELL II. Elliptocyte  Aka ovalocytes CAN BE CLASSIFIED AS  Appear as cigar to egg shaped RBCs  Variation in size  Caused by defects of red cell membrane proteins  Variation in shape  Seen In - Hereditary Elliptocytosis, Megaloblastic anemia,  Variation in hemoglobin content Thalassemia  Inclusion bodies  Alteration in RBC distribution on PBS RED BLOOD CELL (RBC)  Also known as Erythrocytes  Mature RBCs measures 6-8 micrometers o Average - 7.5 um diameter  Thickness - 1.5-2.5 micrometers o Average - 2 um )  Shape - Round, biconcave disc; discocyte  Salmon pink with central pallor III. Codocyte o 1/3 diameter of the cell  Aka Target cells/Mexican hat cell  Bull’s eye appearance; centrally stained with thin outer rim  Associated - Liver disease, Hemoglobinopathie s, Thalassemia 1. VARIATION IN SIZE  Anisocytosis - General term used in hematology to denote an increased variation in cell size of the red blood cells I. Normocytic - Normal size of red blood cell IV. Echinocyte  Aka Crenated cell/ Sea urchin cell  They have regular spicules II. Microcytic  Caused by changes in osmotic pressure  Smaller than the normal size of red blood cell  Seen In - Liver disease, Uremia, PK deficiency  Associated with decrease hemoglobin synthesis  Can Be Seen In o Iron deficiency anemia o Thalassemia o Sideroblastic anemia o Anemia of chronic disease V. Drepanocyte  Aka Sickle cell  Appear as thin, elongated, pointed ends or has crescent shape  Polymerization Hb S  Caused by cell membrane alteration due to amino acid substitution  Hemoglobinopathies III. Macrocytic  Larger than the normal size of red blood cell  Result of a defect in either nuclear maturation or stimulated erythropoiesis  Can Be Seen In - Megaloblastic anemia VI. Schistocyte  Fragmented red cell with pointed projections  Can Be Seen In - MAHA, Uremia, DIC 2. VARIATION IN SHAPE I. Spherocyte  Lacks central pallor  Caused by spectrin deficiency  Associated - Hereditary spherocytosis, G6PD deficiency VII. Dacryocyte  Teardrop cell/ Pear-shaped with one blunt projection  Seen In - Primary myelofibrosis, Thalassemia, Megaloblastic anemia BACHELOR OF SCIENCE IN MEDICAL LABORATORY SCIENCE SXIA  MT303A LEC WEEK 3: RED BLOOD CELL MORPHOLOGY (TRANSCRIPT) BSMLS 4. ERYTHROCYTE INCLUSION BODIES I. Basophilic stippling VIII. Stomatocyte  Aggregated RNA  Aka Mouth cell  Red cells have fine to coarse granular inclusion bodies evenly  Slit like central pallor dispersed throughout the cell  Caused by osmotic changes due to cation imbalance (Na+, K+)  Visualized by Wright stain & Supravital stain (dark blue)  Associated - Rh null, Alcoholism, Severe liver disease  Can Be Seen In - Lead Poisoning, severe anemia II. Cabot rings IX. Acanthocyte  Appear as figure of eight, ringed shape, loop shaped  Aka Thorny cell/Spur cell  Probably microtubules remaining from mitotic spindle  Irregular spiculated remnants  Caused by excessive cholesterol in the membrane  Visualized by Wright/Supravital stain  Associated - Abetalipoproteinemia, McLeod Syndrome,  Can Be Seen In - Pernicious anemia, Lead poisoning, Alcoholic liver disease, Post-splenectomy Abnormal erythropoiesis 3. VARIATION IN HEMOGLOBIN CONTENT  Normal RBC - Has a moderately pinkish-red appearance with a lighter-colored center when stained III. Heinz Bodies  Color in the middle reflects the hemoglobin present in the cell  Represent denatured and precipitated hemoglobin  Anisochromia - General term for a variation in the normal  Must use a SUPRAVITAL STAIN to visualize coloration of RBCs  Associated - G6PD deficiency, Hemoglobinopathies, Beta I. Normochromasia thalassemia major II. Hypochromasia  Central pallor exceeds 1/3 of the cell/s diameter  Associated - Iron deficiency anemia, Thalassemia, Sideroblastic anemia IV. Howell Jolly Bodies  Nuclear remnants predominantly composed of DNA  Appear as round, solid staining, dark- blue to purple inclusion with Wright/ Supravital stain III. Hyperchromasia  Can be seen - Hemolytic anemia, Megaloblastic anemia,  Condition wherein the red cell are deeply stained to Splenectomy, Alcoholism abnormal thickness of cells  Can Be Seen - Macrocytosis, Spherocytosis, Megaloblastic anemia BACHELOR OF SCIENCE IN MEDICAL LABORATORY SCIENCE SXIA  MT303A LEC WEEK 3: RED BLOOD CELL MORPHOLOGY (TRANSCRIPT) BSMLS V. Pappenheimer Bodies  Babesia microti - Infected RBCs are normal in size  Aka Siderotic granules  Dark-staining particles of Iron visualized by means of Prussian blue (iron stain)  Aggregates of mitochondria, ribosomes and iron  Associated - Hemoglobinopathies, seen after splenectomy, Sideroblastic anemia  NUCLEATED RBCs o Indicate bone marrow stimulation or increased erythropoiesis o Associated with thalassemia major, sickle cell anemia, and other hemolytic anemias, erythroleukemia, and myeloproliferative disorders 5. ALTERATION IN RBC DISTRIBUTION I. Rouleaux Formation VI. Parasitic Inclusion in Erythrocytes  Plasmodium falciparum o Malignant Tertian malaria o Normal in size of infected RBCs (young & old) o Maurer’s dots II. Agglutination  Plasmodium ovale o Benign Tertian malaria o Normal to slightly enlarged infected RBCs (young) o Schuffer’s dot GRADING OF HYPOCHROMIA 1+ Area of central pallor is ½ of the cell diameter 2+ Central pallor is 2/3 of the cell diameter 3+ Central pallor is ¾ of the cell diameter 4+ Thin rim of hemoglobin GRADING OF POLYCHROMASIA Percentage of red cell that are polychromatophilic 1+ 3% 2+ 5% 3+ 10%  Plasmodium vivax 4+ >11% o Beningn tertian malaria o Enlarged infected RBCs o Schuffner’s dot  Plasmodium malariae o Quartan malaria o Old normal in size of infected RBs o Ziemann’s dots BACHELOR OF SCIENCE IN MEDICAL LABORATORY SCIENCE SXIA