Variations in shape and distribution of erythrocytes

Published on 04/03/2015 by admin

Filed under Hematology, Oncology and Palliative Medicine

Last modified 04/03/2015

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11 Variations in shape and distribution of erythrocytes

Poikilocytosis is a general term for the presence of abnormally shaped red blood cells. In most cases, we have opted to use the more specific name for each abnormally shaped red blood cell in place of the term poikilocytosis.

Acanthocyte

Spur cell

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FIGURE 11–1A Acanthocytes.

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FIGURE 11–1B Acanthocytes.

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FIGURE 11–1C Acanthocytes; two nucleated red blood cells in field.

Description:

Erythrocyte with irregularly spaced projections that vary in width, length, and number; usually dense, lacking central pallor

Associated with:

Severe liver disease, splenectomy, malabsorption, hypothyroidism, vitamin E deficiency, abetalipoproteinemia

Schistocyte

Schizocyte

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FIGURE 11–2A Schistocytes.

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FIGURE 11–2B Schistocytes.

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FIGURE 11–2C Bite cells.

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FIGURE 11–2D Blister cells.

Color:

Red to salmon

Shape:

Fragmented erythrocytes; many sizes and shapes may be present on a smear; often display pointed extremities

Associated with:

Microangiopathic hemolytic anemia (hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, disseminated intravascular coagulation), severe burns, renal graft rejection

Note:

Bite and blister cells are the result of splenic pitting of Heinz bodies (see Figure 12-5, B). These cells are often included in the schistocyte category.

Echinocyte

Burr cell

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FIGURE 11–3A Echinocytes/burr cells.

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FIGURE 11–3B Echinocytes/burr cells.

Description:

Erythrocyte with short, evenly spaced projections usually with central pallor

Associated with:

Uremia, pyruvate kinase deficiency, microangiopathic hemolytic anemia, neonates (especially premature), artifact

Spherocyte

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FIGURE 11–4A Spherocytes.

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FIGURE 11–4B Spherocytes.

Color:

Darker than surrounding red blood cells

Shape:

Round; no central pallor zone

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