hemato

• Erythrocyte morphology is indicated by


  A clinical request or laboratory flags
• Some abnormal morphology can be artifactual due to poorly made or improperly stained smears
• Abnormal erythrocyte morphology is found in pathological states
• Red cell morphologic disorders

  Evaluated in terms of size, shape, colour, distribution, and intra-cytoplasmic inclusions under the compound microscope
• Polychromasia describes young red cells containing residual RNA in the cytoplasm, having blue, bluish gray, or purple color
• Hypochromia means a decrease concentration of hemoglobin in the RBC and an increase area of central pallor
• Erythrocyte morphology


  Points to possible haemopathies or red cell diseases
• Erythrocytes


  Cannot be seen with the naked eyes
• Variations in size of red cell

  • Normocytes
  • Microcytes
  • Macrocytes
• Anisocytosis is the red blood cells that have different or variation of sizes
• Dichromic population of RBC refers to two populations of red blood cells seen: one normochromic and one hypochromic
• Blood cell morphology


  A key tool in laboratory haematology
• Normal red cell

  Round form, shaped like a disc (bi-concave), contains haemoglobin but no nucleus or organelles
• Deviations from normal morphology


  Associated or perhaps diagnostic of disease entities
• Morphology of red cells


  Performed on peripheral blood smears or in the laboratory
• Poikilocytosis is a general term for the presence of abnormally shaped red blood cells
• Spherocyte

  Erythrocytes that have lost their biconcavity because of a decreased surface area-to-volume ratio, round and no central pallor zone that causes spherocytes to be darker
• Schistocyte

  Fragments of red cells caused by mechanical damage to the cell, variety of shapes including triangles, commas, and helmet-shaped
• Schistocytes are usually microcytic because they are fragments of erythrocytes
• Acanthocytes


  Small spherical cells or spicules of varying length, width, and number irregularly distributed over the surface
• Conditions associated with Acanthocytes

  • Severe liver disease
  • Splenectomy
  • Malabsorption
  • Hypothyroidism
  • Vitamin E deficiency
  • Abetalipoproteinemia
  • Alcoholic liver disease
• There are several nonspecific variations in the shape of erythrocytes associated with different conditions of diseases
• Types of anemias

  • Aplastic
  • Hemorrhage
  • Hemolytic
• Diseases associated with Schistocyte

  • Microangiopathic hemolytic anemia
  • Severe burns
  • Uremia
• Conditions associated with Spherocyte

  • Hereditary spherocytosis
  • Some hemolytic anemias
  • Transfused cells
  • Severe burns
• Dacryocyte

  Elongated at one end to form a teardrop or pear-shaped cell, associated with primary myelofibrosis, thalassemia, and other causes of hematopoiesis
• Recovery from acute hemorrhage

  1. Process item 1

  2. Process item 2

  3. etc...
• Drepanocyte


  Enlongated cell and crescent-shaped erythrocyte with abnormal hemoglobin polymerization under certain conditions
• Conditions associated with Codocytes

  • Hemoglobinopathies
  • Thalassemia
  • Iron deficiency anemia
  • Splenectomy
  • Obstructive liver disease
• Acanthocytes

  RBC have dark red to salmon color and no area of pallor (lack of color)
• Conditions associated with Drepanocyte

  • Homozygous hemoglobin S disease
  • Sickle cell disorder
• Conditions associated with Elliptocyte

  • Hereditary elliptocytosis or ovalocytosis
  • Thalassemia major
  • Iron deficiency anemia
  • Anemia associated with leukemia
• Spherocyte


  The only erythrocyte that can be called hyperchromic because of an increased MCHC (mean cell hemoglobin concentration)
• Echinocyte


  Spiculated red cell with short evenly spaced projections over the entire surface
• Codocytes

  Thin, bell or cup-shaped cells with an increased surface, central concentration of hemoglobin surrounded by a colorless area with a peripheral ring of hemoglobin resembling bull’s eyes
• Conditions associated with Dacryocyte

  • Primary myelofibrosis
  • Thalassemia
  • Other causes of hematopoiesis
• Conditions associated with Echinocyte

  • Uremia
  • Pyruvate kinase deficiency
  • Microangiopathic hemolytic anemia
  • Neonates
  • Liver disease
  • Peptic ulcer
  • Cancer of stomach
  • Heparin therapy
• Elliptocyte

  Vary from elongated oval shapes or egg-shaped erythrocytes to elongated elliptocytes or cigar-shaped, associated with various conditions
• Some abnormal morphology can be artifactual because of poorly made or improperly stained smears
• Stomatocytes


  • Associated with hepatic disorder, hemolytic anemias, and hereditary stomatocytosis