Type of Cell
Description
Disease Associations
Macrocytes
MCV >100fL,
Microcytes
MCV < 80 fL
Echinocyctes
Show uniform round bumps or
spikes on the RBC surface.
Irregular in size with spiny
projections
megaloblastic anemias, liver disease,
newborns
iron deficiency anemias,
thalassemias, sideroblastic anemias,
lead poisoning, renal disease.
Renal disease
Caused by changes in cellular
osmotic pressure.
Pyruvate kinase deficiency, renal
disease, nonimmune acquired
hemolytic anemia
MAHA, alcoholic liver diseases,
Caused by excessive
hereditary acanthocytosis,
cholesterol in the membrane
abetalipoproteinemia
liver disease, Hb SS,SC, S
Considered artifacts if
thalassemia, thalassemia,
appears in only one section of
the smear
Drug induced, burns, hereditary
Normal MCV, increased
spherocytosis, and extravascular
MCHC, and increased osmotic
hemolytic processes
fragility
Megoloblastic anemias, ineffective
erythropoiesis, thalassemia,
sickle cell anemia
Contains hemoglobin S,
Decreased osmotic fragility
microangiopathic hemolytic anemia
Burr cell/Crenated
Acanthocytes
Target Cells/Codocyte/Leptocyte
Spherocytes
Dacryocytes/Teardrops
Drepanocytes/Sickle Cells
Keratocytes/Helmet Cells
Schistocytes
Stomatocytes
small, densely stained RBCs with
multiple irregularly spaced spikes or
clublike projections
Show a central area of hemoglobin
surrounded by colorless ring and a
peripheral ring of hemoglobin
Show no central pallor
Show a tapered and round end.
Slightly smaller than normocytes
Vary; have thin, elongated pointed
ends, and appear crescent shaped
Interior portion of the cell is hollow,
resembling a helmet
RBC fragment
Characterized by an elongated or
slitlike area of central pallor that
resembles a mouth
DIC, burns, renal transplant
rejection and intravascular
hemolytic processes
hereditary stomatocytosis,
alcoholism,
Other
RBC fragmentation results
from passage through
damaged blood vessels
results from increased
sodium and decreased
potassium concentration
within the cytoplasm of RBC
Elliptocytes
Cells have rod, cigar, or sausage
shape
Nucleated RBC
Nucleus in cell
hereditary elliptocytosis, iron
deficiency anemias, megaloblastic
anemia, thalassemia, and sickle cell
anemia
acute blood loss, leukemias,
hypoxia, megaloblastic anemias,
heart disease, and myelofibrosis,
newborns
Caused by membrane
integrity defect
sickle anemia, megaloblastic
anemia, alcoholism, splenectomy,
hemolysis, and hemoglobinopathies
Caused by nuclear
disintegration, fragment
stains blue to purple
Indicate some type of bone
marrow stimulation or
increased erythropoiesis
Erythrocyte Inclusions
Howell-Jolly Bodies
Basophilic Stippling
Cabot Ring
Heinz Bodies
Pappenheimer bodies
Appear as small, round fragment(1
to 2 micrometer in diameter) of
nuclear material (DNA) that may be
single or multiple
Multiple, blue-black, tiny, fine, or
coarse inclusions(ribosomal RNA
remnants) throughout the cell
Thin, blue to reddish-purple, single
to multiple ringlike structure that
may appear in loop or “8” shapes
Results from denatured hemoglobin
Small irregular, dark-staining
granules (iron granules) clumped
together at one end or region
thalassemias, megaloblastic
anemias, lead poisoning, alcoholism,
lead poisoning, pernicious anemia,
and megaloblastic anemia
Remnant of mitotic ring
Glucose-6-phosphate
dehydrogenase deficiency;
sideroblastic anemia, thalassemia,
hemosiderosis, and megaloblastic
anemia
Must use supravital stain to
see
Use Prussian blue for stain
(Just for sake of easy use, I put Bindu’s fabulous powerpoint into a chart. I edited where I thought necessary. I take no credit for this as I used
most of the information Bindu found, and then used the RBC Crib Sheet from Gayle and our book to make some edits).