Presentation on theme: "MLAB 1415: Hematology Keri Brophy-Martinez"— Presentation transcript:
1MLAB 1415: Hematology Keri Brophy-Martinez Chapter 8: AnemiaPart Three
2RBC Shape VariationsAlterations in the shape of the RBC is called poikilocytosis.
3Target Cells (Codocytes) Occur due to an increased red blood cell surface area.Appear as "targets" on peripheral blood smear. Have a pale central area with most of the hemoglobin around the rim of the cell.Are always hypochromic.
4Target Cells (Codocytes) Mechanism in formation is related to excess membrane cholesterol and phospholipid, and to decreased cellular hemoglobin. Osmotic fragility is decreased.
5Target Cells (Codocytes) Seen in patients with:Liver diseaseHemoglobin C Disease or TraitPost-splenectomyIron Deficiency AnemiaAny Hemoglobin AbnormalityCan be artifactual
14Stomatocytes Red cell of normal size Slit-like central area of pallor Exact mechanism of formation unknownUsually artifactual
15StomatocytesOsmotic fragility increased (more permeable to sodium).
16Stomatocytes Associated with following disorders: Hereditary StomatocytosisHemolytic, Acute AlcoholismRh Null Phenotype
17Sickle Cells (Drepanocytes) Have at least one pointed end.Surface area of cell much greater than normal cell.
18Sickle Cells (Drepanocytes) Low oxygen tension causes hemoglobin to polymerize, forming tubules that line up in bundles to deform cell.Most sickle cells can revert back to normal shape when oxygenated.
19Sickle Cells (Drepanocytes) Associated with the following disorders:Sickle Cell AnemiaHemoglobin C Disease
25Fragmented Cells Includes: Burr CellsHelmet CellsSchistocytesFragmentation is defined as a loss of a piece of cell membrane that may or may not contain hemoglobin.
26Fragmented Cells Two pathways that lead to fragmentation: Alteration of normal fluid circulation (vasculitis, malignant hypertension, heart valve replacement).Intrinsic defects of red cell that make it less deformable (spherocytes and antibody-covered red cells).
28Burr Cells (Echinocytes) Red cells with evenly spaced spicules over the surface of the cell. Normocytic and normochromic. In large numbers, are an artifact of sample contamination.
29Burr Cells (Echinocytes) "True" burr cells occur in small numbers in uremia, heart disease, stomach cancer, bleeding peptic ulcers, and in patients with untreated hypothyroidism. Seen in liver disease, renal disease, and burn patients. May occur in any situation that causes change in tonicity of intravascular fluid (dehydration).
30Helmet Cells (Bite Cells) Usually have two projections surrounding an empty area of red cell membrane. Looks as if cell has had a bite taken out of it. Caused by spleenic pitting and impalement of the RBC on fibrin strands
31Helmet Cells (Bite Cells) In conditions where red cells have large inclusion bodies (such as Heinz bodiesG6PD deficiency.May be seen in patients with pulmonary emboli, and disseminated intravascular coagulation (DIC).
32Schistocytes Extreme cell fragmentation Cell is missing whole pieces of membrane. Causes bizarre shapes of red cells.
33Schistocytes Caused by loss of membrane by mechanical means See in patients with microangiopathic hemolytic anemia, DIC, heart valve surgery, or severe burns.
34Teardrop CellsAppear as pear-shaped cells. Length of tail varies. May be microcytic, normocytic, or macrocytic.Exact formation process unknown. Commonly seen in red cells that contain large inclusion bodies.
35Teardrop CellsMost commonly seen in idiopathic myelofibrosis, thalassemia, and iron deficiency anemia.
36ReferencesHarmening, D. M. (2009). Clinical Hematology and Fundamentals of Hemostasis. Philadelphia: F.A Davis.McKenzie, S. B., & Williams, J. L. (2010). Clinical Laboratory Hematology . Upper Saddle River: Pearson Education, Inc.ical-disorders/microscope/stomatocyte.htms/WEBHemOncFiles/Review%20of%20Terms.html