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Category of blood variation in shape "POIKILOCYTOSIS"
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Transcript of Category of blood variation in shape "POIKILOCYTOSIS"
CATEGORY OF BLOOD VARIATION IN SHAPE“POIKILOCYTOSIS”PRINCESS ALEN AGUILAR
A. POIKILOCYTES SECONDARY TO
DEVELOPMENTAL MACROCYTOSIS
OVAL MACROCYTES (OVALOCYTES)
• Inc. MCV
• CS= Megaloblastic Anemia most popular for this cell
• No cental pallor
B. POIKILOCYTES SECONDARY TO MEMBRANE
ABNORMALITIES
SPHEROCYTES
Dec. surface volume to ratio
Defects on RBC membrane CHONs
Spectrin deficiency
CS= Hereditary spherocytosis, AIHA, G6PD, ABO-HDN, RC ENZYME DEF.
Microcytic Hyperchromic anemia
ELLIPTOCYTES “ciggar shape cell”
CS= IDA, Pernicious Anemia, Hereditary elliptocytosis, Myelofibrosis w/ myeloid dysplasia, Megaloblastic Anemia, SCA, Thalassemia, Congenital disorder of diserythropoiesis
ECHINOCYTES (CRENATED RBC)
Short equally spaced projections, regular spicules
Present in prolonged standing artifacts
Resembles to Burr Cells
CS= pyruvate kinase def. , uremia, hepatic therapy, renal insufficiency, suddend change in pH
Burr cells “sea urchin”
Irregular spicules, less pointed
Also seen in Renal failure and uremia
Acanthocytes “Spur cells or thorn cells”
Very spiny irregular projections
CS= Abetalipoproteinemia, cirrhosis, HUS, post splenectomy, HA, PKD
Lysine: Sphingomyosin def.
Stomatocytes “Mouth Cell”
w/ slit like or mouth like central pallor
CS=Rh null Disease, Renal Dse, Liver Dse
Due to osmotic changes
TARGET CELLS/CODOCYTES
MEXICAN HAT CELLS, LEPTOCYTES, PLATYCYTES, BULL’S EYE, GREEK HELMET CELLS
INC. VOLUME RATIO
CS= Liver Dse, Hemoglobinopathies, Thalassemia, IDA
C. POIKILOCYTES SECONDARY TO TRAUMA
SCHISTOCYTES “Fragmentocytes or Egg shells”
Cell fragments
CS= Microangiopathic anemia, thermal injury, renal transplantation rejection, G6PD def, heart velve replacement, HA, severe burns, mechanical destruction due to TTP or DIC
Fragmenting/disintegrating RBC
KERATOCYTES (HELMET CELLS)
Horn like projections
Red cell caught in fibrin strands
Triangle cell, keratocytes of Bessis
FragileCS= Hemolytic
Anemia
DACROCYTES (TEAR DROP)
Round cell wth elongated tail
Cells are squeezed into small opening
CS= Myelofibrosis, Megaloblastic Anemia, Thalassemia, Pernicous Anemia
MICROSPHEROCYTES/ PYROPOIKILOCYTES
Occurs in severe burns
Low MCV
2-3um
D. POIKILOCYTES SECONDARY TO ABNORMAL Hgb CONTENT
SICKLE CELL/ DREPANOCYTES/ MENISCOCYTES
THIN, ELONGATED, POINTED ENDS,
APPEAR CRESCENT SHAPE RBC
LACK CENTRAL PALLOR
Hgbinopathies SS, SC, SD
Hgb CC Crystal
Rhomboid, tetragonal or rod shaped, crystals of dense staining
After splenectomy
CS= Homozygous Hb SC Dse
BLISTER CELL
Red cell w/ single or multiple vacuoles or markedly thinned areas at the periphery
Pre-cursor of helmet cells
Microangiopathic Hemolytic Anemia
DEGMACYTE (BITE CELL)
Drug-induced anemias
G6PD Def., Thalassemia,
Happened due to passing through the blood vessels of the spleen some parts of the cell remains
BASOPHILIC STIPPLING
Fine= Inc. polychromatophilia
Blueberry bagel appearance
CS= Lead poisoning (Plumbism), Impaired Hgb synthesis, MA
Remnants of RBC RNA
HOWELL JOLLY BODIES
Single: nuclear chromatic remnants, MA, HA
Double: MA, Abnormal Erythropoiesis
Large single inclusions
Related to DNA remnants
PAPPENHEIMER BODIES
SIDEROTIC GRANULES
SMALL DARK BLUE PURPLE
PRUSSIAN BLUE= Staining non-heme iron granules
WRIGHTS STAIN= Faint blue
Granules clumped together
CS= Sideroblastic anemia, Hgbinoathies, Thalassemia, MA, myelodysplatic syndrome
CABOT RINGS
Ring shape, figure of 8
Double or several concentrics
Microtubules remnants or mitotic spindle
Rarely seen in PA, lead poisoning
Abnormal erythropoiesis
HEINZ BODIES
Denatured Hgb
Residues of oxidized Hgb
Presence in indicative of RBC injury
w/ alcoholism
G6PD def, unstable Hgb
Hb H INCLUSIONS
“GOLF BALL DENTS”
Multiple blue green spherical inclusins stained with Brilliant Cresyl Blue (BCB)
MALARIAL INCLUSIONS