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

qAcquired

•Neoplasms

•cardiovascular disease

•hepatobiliary disease

•Alcoholism

•Drugs

qHereditary

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

Megaloblastic anemia

•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

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.

MATCH

•whipworms (Trichuris trichiura),

•Goes with B , microcytic hypochromic anemia)

MATCH

•A sickle sell) goes with 2 a bone scan with increased uptake, B (megaloblastic anemia) goeas with 1 terminal ilium affection, while C(abetalipoproteinemia goes with 3 (retinitis pigmentosa)

abetalipoproteinemia