SOME COMMON ABNORMALITIES IN PERIPHERAL BLOOD SMEAR EXAMINATION
- Anisocytosis
Variation in the size of RBC seen in Fe deficiency anemia, megaloblastic anemia, and sideroblastic anemia - Poikilocytosis
Variation in the shape of RBC, seen in Fe deficiency anemia, thalassemia, and sideroblastic anemia. - Microcytosis
RBC size less than normal (< 75 fL), seen in Fe deficiency anemia, thalassemia, and sideroblastic anemia - MacrocytosisÂ
size of RBC> 100 fL seen in vitamin B12 and also folic acid deficiency
- HypochromiaÂ
RBC with less Hb, the increased central pallor is seen in Iron deficiency anemia, thalassemia, sideroblastic anemia
- Basophilic stippling or punctate basophilia
Presence of scattered deep blue dots in the cytoplasm of RBC with Romanowsky staining, seen in pathologically damaged young red cells, severe anemia β thalassemia, and chronic lead poisoning.
- Target cells—Flat red cells with a central mass of Hb (dense area) surrounded by a ring of pallor (pale area) and an outer ring of Hb (dense area), seen in chronic liver diseases, hyposplenism, and hemoglobinopathies.
- Howell-Jolly bodies—seen in non-functioning or absent spleen and megaloblastic anemia.
- Heinz’s bodies (Ehrlich’s bodies)—formed from denatured, aggregated hemoglobin, seen in thalassemia, hemolytic anemia due to G6PD deficiency, asplenia, and chronic liver disase.
- Burn cells—RBC showing regularly placed spicules, seen in uremia.
- Schistocytes—they are fragmented RBCs seen in intravascular bemolysis.
- Spherocytes—small, densely packed RBCs with loss of central pallor, seen in hereditary spherocytosis and immunohemolytic anemias.