Lab CE Course - Erythrocyte Inclusions
Reticulocytes
slightly larger (10 microns) than the mature erythrocyte, appear blue-gray on the Wright- or Wright-Giemsa-stained smear and are referred to as polychromatophilic red cells
Cabot Ring
thin, red-violet-staining strands in the shape of rings, figure eights, or shapes of the letter B on Wright-stained, in megaloblastic anemia, lead poisoning, severe anemia, leukemia, myelodysplastic syndromes, and other cases of dyserythropoiesis
Pappenheimer body
Variable in size and aggregated near cell periphery
Thalassemia and lead poisoning
probably observe coarse basophilic stippling on a Wright-stained peripheral blood smear
Howell-Jolly Body
DNA, nuclear remnants/aggregates of chromosomes that have separated from the mitotic spindle, usually 1 on RBC
Howell-Jolly Body in nucleated red cell
nuclear remnants, they may also be present in the cytoplasm of nucleated red cells
Polychromatophilic RBCs
How would you classify these cells
Ringed sideroblast
If five or more siderotic granules form a ring around at least half the periphery of the nucleus of a nucleated red blood cell, the cell is referred to as
Megaloblastic anemia, lead poisoning
In which of the following conditions might Cabot rings be observed in erythrocytes on a Wright-stained peripheral blood smear
20-60%
of red cell precursors seen in bone marrow slides normally contain siderotic iron granules visible with Prussian blue stain
Siderotic granules
NOT all are visible on Wright-stained smears as Pappenheimer bodies
Ringed sideroblast
NOT present in normal bone marrow and would be associated with a disease or disorder
Basophilic stippling
Relatively evenly distributed coarse granules throughout the cell
Howell-Jolly body
Round and smooth and usually one per erythrocyte
Heinz bodies
Supravital stain; are clumps of precipitated hemoglobin
True
The cell that is indicated by the arrow in this Prussian-blue stained bone marrow smear is a ringed sideroblast
True
The inclusions that are indicated by the arrows on this Wright-Giemsa stained peripheral blood smear are most likely Pappenheimer bodies
polychromatophilic RBCs
This image represents a field of red blood cells (RBCs) that were stained using the supravital stain New Methylene Blue. How would these cells appear if they were viewed on a Wright-stained smear
None
What abnormality is present in this slide
Howell-Jolly Bodies
Which of the following inclusions are composed of DNA
Howell-Jolly and Pappenheimer bodies
Which of the following inclusions may be observed on a Wright-stained peripheral blood smear if a patient has had a splenectomy
Prussian blue stain: Pappenheimer bodies stain blue but Howell-Jolly bodies do not stain blue
Which of these methods could be used to differentiate between Howell-Jolly bodies and Pappenheimer bodies and what results would be noted
lead poisoning
associated with coarse basophilic stippling
Polychromatophilic RBCs
blue-gray appearance when compared to the other RBCs, often larger than mature RBCs, either lack central pallor or have diminished central pallor
Siderocyte
cell may or may not have been visible on a Wright-stained
Reticulum visible with a supravital stain, such as new methylene blue Contains some organelles used for hemoglobin production
characterize a reticulocyte
DNA
composition of Howell-Jolly bodies
aggregates of ribosomes
composition of the granules associated with basophilic stippling
Hyposplenism, Megaloblastic anemia
conditions you expect to find Howell-Jolly bodies
Basophilic stippling
dark-blue or blue-purple granules predominantly RNA, may indicate impaired Hgb synthesis, probably due to the RNA instability, coarse in sideroblastic anemias, lead poisoning, myelodysplasias, and thalassemias
Halo around the platelet
distinguishing characteristic of platelet on RBC
One
how many Howell-Jolly bodies are usually seen within a given erythrocyte
Sideroblast
immature erythrocyte containing siderotic granules
Sideroblast
indicated by the red arrow, is a nucleated red cell containing siderotic granules
Pappenheimer bodies
mature and immature RBCs, Wright-stain, confirmed with Prussian blue, small dark purple granular bodies varying size, clusters in groups of two, three, or more near cell edge, degenerating cellular remnants containing iron, accelerated red cell division or impaired hemoglobin synthesis, sideroblastic anemia, thalassemia, postsplenectomy
Siderocyte
mature erythrocyte containing siderotic granules
erythrocyte inclusions
may indicate the presence of disease