Hematology and Oncology Book

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Erythrocyte Morphology on Peripheral Smear

Aka: Erythrocyte Morphology on Peripheral Smear, Erythrocyte Morphology, Red Blood Cell Morphology, Macrocyte, Microcyte, Spherocyte, Elliptocyte, Schistocyte, Acanthocyte, Spur Cell, Dacryocyte, Howell-Jolly, Target Cell, Basophilic Stippling, Sideroblast, Cabot's Ring Bodies
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  1. See Also
    1. Red Blood Cell
    2. Peripheral Smear
    3. Bone Marrow Exam
  2. Background
    1. Variants below as seen on Peripheral Smear
    2. RBC Evaluation parameters
      1. RBC Color
      2. RBC Size
      3. RBC Shape
      4. RBC Contents
  3. Causes: Macrocytes
    1. See Macrocytic Anemia
    2. Reticulocytosis
    3. Liver disease
  4. Causes: Hypochromic Microcytes: Defective Hemoglobin synthesis
    1. See Microcytic Anemia
    2. Iron Deficiency Anemia
    3. Thalassemia
    4. Sickle Cell Anemia
    5. Hemoglobinopathy
  5. Causes: Spherocytes
    1. Hereditary spherocytosis
    2. Autoimmune Hemolytic Anemia
    3. Acute Alcoholism
    4. Hemoglobin C Disease
    5. Following severe Burn Injury
    6. Hemolytic transfusion reactions
    7. Severe Hypophosphatemia
    8. Acute Oxidant Injury: Hexose Monophosphate Shunt Defect
    9. Clostridium Welchii Septicemia
  6. Causes: Elliptocytes (Oval Cells)
    1. Megaloblastic Anemia
    2. Myelofibrosis
    3. Refractory normoblastic Anemia
    4. Hereditary elliptocytosis
    5. Thalassemia
  7. Causes: Schistocytes (Fragmented Red Blood Cells)
    1. Microangiopathic Hemolytic Anemia
      1. Disseminated Intravascular Coagulation (DIC)
      2. Thrombotic Thrombocytopenic Purpura (TTP)
      3. Hemolytic Uremic Syndrome (HUS)
      4. Giant Hemangioma
      5. Metastatic Carcinoma
      6. Malignant Hypertension
      7. Eclampsia (Toxemia of Pregnancy)
      8. Vasculitis
    2. Macroangiopathic Hemolytic Anemia
      1. Prosthetic Heart Valve
  8. Causes: Dacryocytes (tear drop RBC)
    1. Extramedullary hemopoiesis
    2. Myelophthisic Anemia
    3. Severe Hemolytic Anemia
    4. Erythroleukemia
  9. Causes: Acanthocytes (Spur Cells)
    1. Abetalipoproteinemia
    2. Cirrhosis
    3. Hepatic necrosis
    4. Pyruvate kinase deficiency
    5. Uremia
    6. Infantile pyknocytosis
  10. Causes: Howell-Jolly Bodies
    1. Postsplenectomy
    2. Megaloblastic Anemia
  11. Causes: Basophilic Stippling (aggregated ribosomes)
    1. Lead Poisoning
    2. Arsenic Poisoning
    3. Thalassemia
    4. Sideroblastic Anemia
    5. Hemolytic Anemia
    6. Severe Anemia
    7. Unstable Hemoglobin
    8. Pyrimidine 5'-Nucleotidase Deficiency
  12. Causes: Heinz Body (Aggregates of denatured Hemoglobin)
    1. Oxidative Hemolytic Anemia (G6PD Deficiency)
  13. Causes: Target Cells
    1. Thalassemia
    2. Hemoglobin C
    3. Hemoglobin S (Sickle Cell Anemia)
    4. Liver Disease
  14. Causes: Sideroblasts
    1. See Sideroblastic Anemia
    2. Nucleated RBCs
    3. Iron laden mitochondria
  15. Causes: Cabot's Ring Bodies (Nuclear remnants)
    1. Lead Toxicity
    2. Pernicious Anemia
    3. Hemolytic Anemia
  16. Causes: Other findings on RBC exam
    1. Malaria
    2. Bartonella parasites
  17. References
    1. Ravel (1995) Clinical Laboratory Medicine, p. 14-16

Acanthocytes (C0000886)

Definition (MSH) Erythrocytes with protoplasmic projections giving the cell a thorny appearance.
Definition (NCI) Erythrocytes with protoplasmic projections giving the cell a thorny appearance. (MeSH)
Concepts Cell (T025)
MSH D000050
SnomedCT 259685005, 63599005, 250250008
English Acanthocytes, SPUR CELL, cells spur, acanthocyte, acanthocytes, acanthrocyte, spur cell, Acanthocyte, Acanthrocyte, Crenated cell, Spur cell, Acanthocyte (cell), Spiny prickle cell, Acanthocyte (morphologic abnormality), Acanthocyte [dup] (morphologic abnormality), Spur cell (finding)
French Érythrocytes en anneaux, Acanthocytes, Acanthocyte
Swedish Akantocyter
Czech akantocyty
Finnish Piikkisolut
Russian AKANTOTSITY, АКАНТОЦИТЫ
Latvian Akantocīti
Polish Akantocyty
Spanish acantocito (anomalía morfológica), acantocito (célula), acantocito (hallazgo), acantocito [dup] (anomalía morfológica), acantocito [dup], acantocito, Acantocitos
German Akanthozyten
Italian Acantociti
Dutch Acanthocyt, Acanthocyten
Portuguese Acantócitos
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Spherocytes (C0037888)

Definition (MSH) Small, abnormal spherical red blood cells with more than the normal amount of hemoglobin.
Definition (NCI) Small, abnormal spherical red blood cells with more than the normal amount of hemoglobin. (MeSH)
Concepts Cell (T025)
MSH D013102
SnomedCT 17235000, 259682008
English SPHEROCYTES, Spherocytes, spherocytes, spherocyte, Spherocyte, Spherocyte (cell), Spherocyte (morphologic abnormality)
French Sphérocytes, Sphérocyte
Swedish Sfärocyter
Czech sférocyty
Finnish Pallopunasolut
Russian SFEROTSITY, СФЕРОЦИТЫ
Latvian Sferocīti
Polish Sferocyty
Spanish esferocito (anomalía morfológica), esferocito (célula), esferocito, Esferocitos
German Kugelzellen, Sphärozyten
Italian Sferociti
Dutch Kogelcel, Sferocyt, Sferocyten
Portuguese Esferócitos
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Dacryocyte (cell) (C0221266)

Concepts Cell (T025)
SnomedCT 47787007
English TEAR DROP CELLS, Dacryocyte (cell), Dacryocytes, teardrop cells, tear drop cell, tear drop cells, dacrocytosis, teardrop cell, Tear drop cell, Dacryocyte, Teardrop cell, Dacryocyte (morphologic abnormality)
Spanish lacrimocitos, células lagrimales, eritrocito con forma de lágrima, dacriocito (anomalía morfológica), dacriocito (célula), dacriocito
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Elliptocyte (cell) (C0221280)

Concepts Cell (T025)
SnomedCT 45028007, 57882002
English ELLIPTOCYTES, OVALOCYTES, Elliptocyte (cell), Ovalocytes, Elliptocytes, Pencil cells, pencil cell, elliptocyte, ovalocytes, elliptocytes, pencil cells, ovalocyte, Elliptocyte, Ovalocyte, Pencil cell, Pencil cell (cell), Elliptocyte (morphologic abnormality), Pencil cell (morphologic abnormality)
Spanish célula en lápiz (anomalía morfológica), célula en lápiz (célula), célula en lápiz, eliptocito (anomalía morfológica), eliptocito (célula), eliptocito, ovalocito
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Schistocyte (C0221282)

Concepts Cell (T025)
SnomedCT 165480001, 142889005, 142887007, 70310009, 250245002
English SCHISTOCYTES, Schistocyte, Schistocytosis, Schistocytes, Schistocytosis (finding), SCHISTOCYTE, Helmet cells, cells fragmenting, helmet cells, schistocytes, schistocytosis, cells fragmented, helmet cell, schistocyte, Fragmented cell, Helmet cell, Schistocyte (cell), Helmet cell (finding), Schistocyte (morphologic abnormality)
Spanish Schistocytosis, célula en casco, célula fragmentada, eritrocitos con forma de yelmo (hallazgo), eritrocitos con forma de yelmo, esquistocito (anomalía morfológica), esquistocito (célula), esquistocitosis, esquistocito
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Sideroblast (C0229630)

Concepts Cell (T025)
SnomedCT 53838007
English sideroblast, sideroblasts, Sideroblast (cell), Sideroblast (body structure), Sideroblast
Spanish sideroblasto (célula), sideroblasto
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Macrocytic erythrocyte (C0333805)

Definition (NCI) An abnormally large red blood cell occurring mainly in anemias (as pernicious anemia), also called megalocyte. Lack of vitamin B12 and folic acid could also cause macrocytes. (NCI)
Concepts Cell (T025)
SnomedCT 259681001, 57457008
English Megalocyte, megalocytes, megalocyte, macrocytes, macrocyte, Macrocyte, Macrocytic erythrocyte (cell), Macrocyte (morphologic abnormality), Macrocytic erythrocyte, Macrocytes, Macrocytic Red Blood Cell
Spanish macrocito, eritrocito macrocítico (célula), eritrocito macrocítico, macrocito (anomalía morfológica)
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Microcytic erythrocyte (cell) (C0369668)

Concepts Cell (T025)
SnomedCT 397022008, 57457008
English Microcytic erythrocyte (cell), Microcytes, microcyte, erythrocytes microcytic, microcytes, Microcyte, Microcytic erythrocyte, Microcyte (morphologic abnormality), Microcytic Red Blood Cell
Spanish eritrocito microcítico (célula), eritrocito microcítico, microcito (anomalía morfológica), microcito
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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