blood film

Normal RBCs morphology

NORMAL RBCs MORPHOLOGY

Iron Deficiency Anemia

Note two signs particularly common in IDA, pica and spooning of the nails (koilonychia)

IDA

Note microcytic and hypochromic cells

Lead poisoning

Note the microcytic hypochromic anemia with basophilic stippling of some RBCs

Thalassemia

A child with HSM, characteristic facies and hair on end appearance in x ray

Thalassemia

Target cells

Elliptocytosis

Patient presented with mild hemolytic anemia

Target cells

•Chronic liver disease in which the cell membrane is loaded with cholesterol .

•In varying numbers in iron deficiency aneamia and thalassemia

•Hemoglobinpathic :

–Hb CC disease

–Hb ss

–Hb S/thalassemia

–Hb EG thalassemia

•After splenectomy : even post traumatic renal person .

Target cells

Stomatocytes

Acquired
Neoplasms
cardiovascular disease
hepatobiliary disease
Alcoholism
Drugs
Hereditary

Spherocytosis

This is a blood film of 9 months old girl presented with pallor,

note many spherocytes and one Ghost cell( arrow)

Microcytic hypochromic anemia

•A child presented with severe pallor and easy fatigability.

Microcytic hypochromic RBCs of IDA

helmet cells in HUS

helmet cells in HUS

Macrocyte (black arrow)
Macroovalocyte (blue arrow)
Hypersegmanted neutrophil

Sickle cells in SCD

Macrocyte (black arrow)
Macroovalocyte (blue arrow)
Hypersegmanted neutrophil

Target cells in hemoglobinopathy

Macrocyte (black arrow)
Macroovalocyte (blue arrow)
Hypersegmanted neutrophil

Thalassemia major

Target cells
Bizarre shaped cells
Normoblasts (nucleated RBCs, arrow)

Sickle cell anemia

This is the blood film of a 14 years old boy presenting with polyuria and painful erection.

Acanthocytes abetalipoproteinemia

SCA

Microcytic hypochromic anemia with basophilic stippling- Lead poisoning

Target and sickle cells in patient with sickle thalassemia

Target cells

Different RBCs abnormalities

Match

A will go with 3 (blast cells in leukemia with gum hypertrophy,

B goes with 1 sickle cells and leg ulcers

C goes with 2 megaloblastic anemia and glazed tongue

What is the abnormal finding in this blood films

Anisocytosis and

Poikilocytosis

Note the different shape and size of the RBCs

NEONATAL ANEMIA

Like burr cells, acanthocytes are spiculated from the changes in the lipid layers. The spikes on acanthocytes, however, are of varying sizes and occur at irregular intervals.
Acanthocytes , Burr cells (arrow) and target cells in a case of Vit E defeciency hemolytic anemia.

Sites of examination for pallor at the palmar crease and conjunctiva

Macrocytic anemia and red glazed tongue, Vitamin B12 deficiency

Hereditary Spherocytosis

Spur Cells (acanthocyte)

Target Cells

Erythrophagocytosis

Erythrophagocytosis by neutrophils is a rare morphological phenomenon described in patients with clonal malignancies of haematopoiesis with myelodysplasia and in some haemolytic conditions including paroxysmal cold haemoglobinuria, haemolysis caused by snake-bite, sickle cell anaemia and other defects of red cells.

Mega thrombocyte- ITP

Erythrophagocytosis by neutrophils is a rare morphological phenomenon described in patients with clonal malignancies of haematopoiesis with myelodysplasia and in some haemolytic conditions including paroxysmal cold haemoglobinuria, haemolysis caused by snake-bite, sickle cell anaemia and other defects of red cells.