Hematology 1 LECTURE

MIDTERMS
RED CELL MORPHOLOGY CAUSES:
o Iron deficiency anemia
NORMAL RBC o Thalassemia
● Fragile, Biconcave, disk-like structure.
o Smooth round surface
● Diameter: 7.5-7.8um.
o Appears to be the same size as the
nucleus of the small lymphocytes
o Have no nucleus
● Whole cell is filled with the hemoglobin.
o The red color of red cells is due to the POIKILOCYTOSIS
presence or hemoglobin → variation of shapes
o RBCs survive for approximately shapes of RBCs vary more than expected in
normal individuals.
NORMOCYTIC TYPES:
→ expresses normal size of RBCs.
 Spherocytes
 Ovalocytes
NORMOCHROMIC
→ indicates normal morphology  Burr cells
● Mature red blood cells, under normal  Created red cells
circumstances, will also have an appropriate  Schistocytes
hemoglobin content.  Tear drop cells
o Red-orange appearance on Wright-  Acanthocytes
stained smears.  Target cells
o Cells will display a central pallor no  Sickle cells
larger than 3 microns in diameter.  Pencil cells
● Paramount for RBCs to contain an adequate
amount of hemoglobin for the purpose of SPHEROCYTES
transporting oxygen to the tissues and carbon → small densely staining spherical red cells
dioxide back to the lungs. with no central pallor area
Causes:
ABNORMALITIES OF RBC o Hemolytic anemia
o Drugs induced
ANISOCYTOSIS o Snake venom
→ variation of size o Infection with C. perfringens
In the same blood film, beyond normal limits. o Hereditary spherocytosis
o ABO hemolytic disease of the newborn
MACROCYTOSIS
→ abnormal structures present in red cells
having certain staining characteristics.
Causes:
o liver disease
o megaloblastic anemia
o aplastic anemia
o obstructive airway disease
o excess of alcohol
o
MICROCYTOSIS
→ Average size of RBC in blood film is less
than normal.

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Hematology 1 LECTURE
MIDTERMS
OVALOCYTES SICKLE CELLS
→ oval shaped red cells. → Thin crescent shaped, or boat shaped cells
About 10% RBC in a normal blood film, elongated, deeply staining red cells with
particularly at the tail end, appear oval and less pointed ends.
commonly elliptical in shape. → May be straight, curved or of various other
Causes: shapes.
o Iron Deficiency Anemia → Produced by polymerization of HbS in sickle
o Megaloblastic Anemia cell disease.,
Causes:
● Sickle cell disease
o Sickle Cell Anemia (S/S)
o Sickle Cell Thalassemia

PENCIL CELLS
→ Elongated narrow red cells
Causes:
o Iron Deficiency Anemia

ACANTHOCYTES
→ Irregularly crenated cells with irregularly
spaced sharp projections.
TARGET CELLS → Small number of spicules of inconstant
→ hypochromic red cells showing central spot length, thickness, shape, irregularly disposed
of Hb over the surface of the cell.
Causes: Causes:
o Thalassemia syndromes o Associated with abnormal phospholipids
o Sickle cell disease metabolism or with inherited
o Hbc disease abnormalities of red cell membrane
o Hbd disease proteins. After splenectomy,
o Obstructive jaundice hypersplenism and in sever liver
o Liver disease disease.
o Post splenectomy

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Hematology 1 LECTURE
MIDTERMS
TEAR DROP CELL Echinocytes:
→ Cells shaped like tear drops.
→ also called Pear-shaped cell.
Cause:
o Iron-Deficiency Anemia

BURR CELLS
→ also, echinocytes but their spicules are
reversible.
Caused by:
SCHISTOCYTES
o Uraemia
→ Fragmented red blood cells of various
o acute blood loss
shapes and sizes.
o Pyruvate kinase deficiency
Caused by red cell damage due to
o Severe burns
STOMATOCYTE
o Drugs
In dry films, the central biconcave area
o Toxins
appears slit like.
o Disseminated intravascular coagulation
In wet preparations, it is a cup shaped red cell.
(DIC)
Seen in:
o Uremia
o Hereditary stomatocytosis
o Liver disease
o Alcoholism

ECHINOCYTES
→ also known as Crenated Cells
→ have evenly distributed blunt spicules of
uniform size on their surface.
Seen in These are formed if anticoagulated
blood is allowed to stand for long periods. INCLUSION IN RBC
→ abnormal structures present in red cells
having certain staining characteristics.

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Hematology 1 LECTURE
MIDTERMS
HOWELL-JOLLY BODIES ● With a supravital stain like Crystal Violet,
→ Small (<1 μm in diameter) rounded Heinz bodies appear as Round Blue
fragments of the nuclear material staining Precipitates.
reddish blue to blue-black. ● Presence of Heinz bodies indicates red cell
→ These usually occur singly in RBC but may injury and is usually associated with G6PD-
be multiple. deficiency.
→ During maturation in the bone marrow
erythrocytes normally expel their nuclei, but in
some cases a small portion of DNA remains.
Causes:
o Splenectomy
o Splenic atrophy
o Alcoholism
o Sickle cell anemia
o Megaloblastic anemia SIDEROCYTES
→ red cells containing non-hemoglobin iron
granules, iron granules appear bright blue.
→ found in hemolytic anemia.

CABOT RINGS
→ Reddish-blue threadlike rings in RBCs.
→ Remnants of the nuclear membrane and
appear as a ring or figure 8 pattern.
Seen in:
o Megaloblastic anemia
o severe anemia BASOPHILIC STIPPLING
o lead poisoning → Fine to coarse, deep blue to purple, small
o Dyserythropoiesis but multiple inclusions of varying sizes.
→ They are given the name due to purplish
color.
Normally one in 10000 cells may show
basophilic stippling.
Increased in:
o Thalassemia
o Megaloblastic anemia
o Liver disease
o Lead poisoning
o Infections

HEINZ BODIES
→ Represent areas of denatured hemoglobin.
→ Highly refractile bodies near the periphery of
cell in unstained wet cover glass preparation.

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Hematology 1 LECTURE
MIDTERMS
MALARIAL PARASITE
Forms:
o Trophozoite
o Schizont
o Gametocytes

ROLEAUX FORMATION
→ stack like arrangement of red blood cells in
blood or in diluted suspensions of blood in
which their biconcave surfaces are next to
each other.
● RBC's here have stacked together in long
chains.
● Known as "rouleaux formation"
→ It happens with increased serum proteins,
particularly fibrinogen and globulins.

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