LabCE Course - Red Cell Disorders: Peripheral Blood Clues to Nonneoplastic Conditions

Schistocytes

(DIC) based on clinical findings and laboratory results that include decreased platelets and fibrinogen, elevated D-dimer, prolonged prothrombin time (PT), and activated partial thromboplastin time(aPTT).

Stomatocytes

may be suggestive of an individual possessing the Rh null phenotype

Spherocytes Polychromatophilic cells

A 12-year-old child presents with jaundice and scleral icterus. The image to the right captures a representative section of the peripheral blood smear. Which of the following are significant findings that should be included on the report

nRBCs Polychromatophilic cells Spherocytes

A 49-year-old male with pneumonia was treated with high-dose intravenous penicillin. He became jaundiced with yellow sclera. The image on the right is typical of other fields that were observed on his peripheral blood smear

Hemolytic uremic syndrome

A 5-year-old girl was brought to the emergency department with bloody diarrhea and severe abdominal pain

Pappenheimer bodies

A 66-year-old man has been diagnosed with sideroblastic anemia. The inclusions indicated by the arrows in the image were seen in many of the RBCs on his Wright-stained peripheral blood smear. What is the identity of these inclusions

nRBCs Spherocytes Polychromatophilic cells Howell-Jolly Bodies

A known case of hemolytic disease of the newborn (HDN) is presented in the image on the right. Many different cellular morophologies are present. Apart from the obvious anisocytosis (microcytes and macrocytes), which additional red blood cell morphologies are worth reporting

Vitamin B12 deficiency Folate deficiency

A patient has an elevated MCV on the automated CBC and a peripheral blood smear is reviewed. A representative field is shown on the right. What conditions could cause the RBC and WBC morphologies that are present in this microscopic field

G6PD deficiency

A ten-year-old boy came to a physician's attention because of recent jaundice and icteric sclerae after taking the medication Primaquine. The immediate laboratory work revealed: Hct 24%(normal 36%-47%), MCV 79.5 fL (normal 78-95fL),RDW 13%(normal 11.5-15.0%).

Basophilic stippling

A toddler is being treated for lead poisoning. You observe the inclusions indicated by the arrows in many RBCs on the peripheral blood smear. What is the identity of these inclusions

Howell-Jolly body

A twenty-five-year-old asplenic male with disseminated lymphoma is admitted to the hospital. A CBC is ordered, and a peripheral blood smear is triggered for review. The image on the right is a representative field from the blood smear. What RBC inclusion is indicated by the arrow

Iron deficiency anemia

Decreased MCV and microcytosis, which one is ruled out

Sideroblastic anemia

Note the iron-stained bone marrow preparation in the image to the right. The cells as shown can be associated with which type of anemia

Pappenheimer bodies

The upper image on the right is a Wright-stained smear. The lower image is a Prussian blue-stained smear made from the same blood specimen (Prussian blue is an iron stain). What are the RBC inclusions indicated by the arrows in the upper image

False

Sickle cells along with target cells, as shown in this image, confirm a diagnosis of sickle cell disease (HbSS)

Transfusion dimorphism

The condition highly associated with the peripheral blood picture in the image on the right is

Megaloblastic anemia

The image on the right contains oval macrocytes and a hypersegmented neutrophil. What condition is associated with these findings

Elliptocytes Schistocytes

This slide is from a 28-year-old female who received a kidney transplant preceded by a splenectomy six months ago. What red cell morphologic abnormalities should be reported

Howell-Jolly bodies

What is the identification of the red blood cell inclusions indicated by the arrows on this peripheral blood smear image

Basophilic stippling

What is the identity of the erythrocyte inclusion indicated by the arrow on this image of a Wright-stained peripheral blood smear

Hereditary spherocytosis

Which hematologic condition could be associated with the findings shown in these images

G6PD deficiency

Which of the following conditions is associated with the defective erythrocytes indicated by the arrows in these images

Teardrop cells (dacrocytes)

clue to the diagnosis of chronic idiopathic myelofibrosis (primary myelofibrosis). What is the identity of these cells