1. CATEGORY OF BLOOD
VARIATION IN SHAPE
“POIKILOCYTOSIS”
PRINCESS ALEN AGUILAR

3. OVAL
MACROCYTES
(OVALOCYTES)
• Inc. MCV
• CS=
Megaloblas
tic Anemia
most
popular for
this cell
• No cental
pallor

5. SPHEROCYTES
 Dec. surface volume to ratio
 Defects on RBC membrane CHONs
 Spectrin deficiency
 CS= Hereditary spherocytosis, AIHA, G6PD, ABOHDN, RC ENZYME DEF.
 Microcytic Hyperchromic anemia

6. ELLIPTOCYTES
“ciggar shape cell”
 CS= IDA, Pernicious Anemia, Hereditary
elliptocytosis, Myelofibrosis w/ myeloid
dysplasia, Megaloblastic
Anemia, SCA, Thalassemia, Congenital disorder of
diserythropoiesis

7. 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

8. Burr cells “sea urchin”
 Irregular spicules, less pointed
 Also seen in Renal failure and uremia

9. Acanthocytes
“Spur cells or thorn cells”
 Very spiny irregular projections
 CS= Abetalipoproteinemia, cirrhosis, HUS, post
splenectomy, HA, PKD
 Lysine: Sphingomyosin def.

10. Stomatocytes “Mouth Cell”
 w/ slit like or mouth like central pallor
 CS=Rh null Disease, Renal Dse, Liver Dse
 Due to osmotic changes

11. TARGET CELLS/CODOCYTES
 MEXICAN HAT
CELLS, LEPTOCYTES, PLATYCYTES, BULL’S
EYE, GREEK HELMET CELLS
 INC. VOLUME RATIO
 CS= Liver Dse, Hemoglobinopathies, Thalassemia, IDA

13. 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

14. KERATOCYTES (HELMET CELLS)
Horn like
projections
Red cell caught in
fibrin strands
Triangle
cell, keratocytes
of Bessis
Fragile
CS= Hemolytic
Anemia

15. DACROCYTES (TEAR DROP)
 Round cell wth elongated tail
 Cells are squeezed into small opening
 CS= Myelofibrosis, Megaloblastic
Anemia, Thalassemia, Pernicous Anemia

16. MICROSPHEROCYTES/
PYROPOIKILOCYTES
 Occurs in severe burns
 Low MCV
 2-3um

18. SICKLE CELL/ DREPANOCYTES/
MENISCOCYTES
 THIN, ELONGATED, POINTED ENDS,
 APPEAR CRESCENT SHAPE RBC
 LACK CENTRAL PALLOR
 Hgbinopathies SS, SC, SD

19. Hgb CC Crystal
 Rhomboid, tetragonal or rod shaped, crystals of dense
staining
 After splenectomy
 CS= Homozygous Hb SC Dse

20. BLISTER CELL
 Red cell w/ single or multiple vacuoles or markedly
thinned areas at the periphery
 Pre-cursor of helmet cells
 Microangiopathic Hemolytic Anemia

21. 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

22. BASOPHILIC STIPPLING
 Fine= Inc. polychromatophilia
 Blueberry bagel appearance
 CS= Lead poisoning (Plumbism), Impaired Hgb
synthesis, MA
 Remnants of RBC RNA

23. HOWELL JOLLY BODIES
 Single: nuclear chromatic remnants, MA, HA
 Double: MA, Abnormal Erythropoiesis
 Large single inclusions
 Related to DNA remnants

24. 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

25. CABOT RINGS
 Ring shape, figure of 8
 Double or several concentrics
 Microtubules remnants or mitotic spindle
 Rarely seen in PA, lead poisoning
 Abnormal erythropoiesis

26. HEINZ BODIES
 Denatured Hgb
 Residues of oxidized Hgb
 Presence in indicative of RBC injury
 w/ alcoholism
 G6PD def, unstable Hgb

27. Hb H INCLUSIONS
“GOLF BALL
DENTS”
Multiple blue
green spherical
inclusins
stained with
Brilliant Cresyl
Blue (BCB)

28. MALARIAL INCLUSIONS