Peripheral Blood Films Flashcards
What cells are described as “RBCs show many irregular sharp spicules” on peripheral blood film and what underlying conditions cause this?
Acanthocytes (spur/spike cells)
Liver disease
Hyposplenism
Abetalipoproteinaemia
Basophilic RBC stippling (description, causes)
“small dots in the periphery”
Lead poisoning Liver disease Megaloblastic anaemia Myelodysplasia Haemoglobinopathy (e.g. thalassaemia)
Burr cells/echinocytes (description, causes)
“like a sea urchin with regular blunt spicules”
Uraemia
GI bleeding
Stomach carcinoma
Often an artefact if blood has sat in EDTA prior to film being made
What cells are described as “inclusions on very edge of RBCs” on peripheral blood film and what underlying conditions cause this?
Heinz bodies (due to denatured Hb)
!!G-6-P dehydrogenase deficiency
Chronic liver disease
Howell-Jolly bodies (description, causes)
“basophilic/purple spot nuclear remnants in RBC” (much bigger purple spots in nucleated RBCs)
Post-splenectomy or hyposplenism (e.g. !!SCD, coeliac, congenital, UC/Crohn’s, myeloproliferative disease, amyloid)
!!Megaloblastic anaemia
Hereditary spherocytosis
What does “leucoerythroblastic anaemia” describe in a peripheral blood film and what is it caused by?
Presence of nucleated RBCs AND myeloid precursors in peripheral blood
Marrow infiltration i.e. myelofibrosis, malignancy
What cells are described as “hyposegmented neutrophil with dumbell-like 2 lobes” on peripheral blood film and what underlying conditions cause this?
Pelger Huet cells
Congenital (lamin B receptor mutation)
Acquired - myelogenous leukaemia, !!myelodysplastic syndromes
What does “polychromasia” describe, which cells does this usually occur in, and what causes this?
Bluish RBCs due to presence of DNA
Usually !!reticulocytes which are immature RBCs
Increased in response to shortened RBC life so
RAISED in !!haemolytic anaemias
LOWERED in !!aplastic anaemia, chemo
What does “right shift” describe on a peripheral blood film and what causes this?
Hypermature white cells - hypersegmented polymorphs (>5 lobes to nucleus)
!!Megaloblastic anaemia
Uraemia
Liver disease
What is a “Rouleax formation” and what causes this?
RBCs stacked on each other
Chronic inflammation
Paraproteinaemia
!!Myeloma
Schistocytes (description, causes)
Fragmented parts of RBCs, typically irregularly shaped with sharp edges and no central pallor
Microangiopathic anaemia
- !!DIC
- !!Haemolytic uraemic syndrome
- !!Thrombotic thrombocytopenic purpura
- Pre-eclampsia
Spherocytes (description, causes)
Sphered-shaped RBC, often slightly smaller
Autoimmune haemolytic anaemia
Hereditary spherocytosis
Stomatocytes (description, causes)
Central pallor is straight or curved rod-shape. RBCs appear as ‘smiling faces’ or ‘fish mouth’
High alcohol intake
Liver disease
Hereditary stomatocytosis
CAN be an artefact during slide preparation
Target cells (codocytes) (description, causes)
Bullseye appearance in central pallor
Liver disease
Hyposplenism
Thalassaemia
IDA (iron-deficiency anaemia)
