July 31, 2019 posted by

The Peripheral blood smear. This generic term is used when the red blood cell shape changes are so varied, that using specific terms does not provide additional diagnostic meaning. Obtaining a blood sample from some people may be more difficult than from others. Cells of normal size and hemoglobin content color are termed normocytic and normochromic. Evaluation for significant shape abnormalities requires a well-made blood film prepared from fresh blood, so that artifactive shape changes are not superimposed upon any of potential pathologic significance. True burr cells are less numerous. Online laboratory continuing education for clinical laboratories and med techs. Peripheral Blood Smear – Clinical Methods.

Morphologic abnormalities of peripheral blood cells are discovered by microscopic examination with the oil immersion lens of well-prepared films of peripheral blood stained with Wright’s stain. A predominance of hypochromic microcytic cells is found in iron deficiency anemia, thalassemia, and hereditary sideroblastic anemia, and in some patients with the anemia of chronic disorders and with lead intoxication. Echinocytosis is a reversible condition of red blood cells that is often merely an artifact produced by EDTA , which is used as an anticoagulant in sampled blood. Leukoerythroblastic anemia Myelofibrosis Severe iron deficiency Thalassemia major The presence of Howell-Jolly bodies may indicate: Macrocytes usually reflect abnormal erythropoiesis in which there is a reduced number of cell divisions during maturation of erythroid precursors. Other risks associated with having blood drawn are slight but may include: The presence of elliptocytes may be a sign of hereditary elliptocytosis or hereditary ovalocytosis. Home Products Most Popular Contact.

PubMed Links to PubMed. Role of abnormal plasma high density lipoproteins”. The projections of the cell membrane may be sharp or blunt, are usually numerous, and tend to be evenly spaced around the circumference.

Ann Biol Clin Paris. Excessive bleeding Fainting or feeling light-headed Hematoma blood accumulating under the skin Ecninocytes a slight risk any time the skin is broken Special considerations The accuracy of this test depends, in part, on the experience of the person looking at the sample.

However, in some situations, there are so many red blood cell shapes or there are some shapes that defy description that the generic term poikilocytosis suffices and provides the same information as identifying each red blood cell shape individually.


White Blood Cell Differential Simulator. Talk to your doctor about the meaning of your specific test results.

Spherocytes may also be observed in less common hemolytic states such as the Heinz body hemolytic anemias and clostridial sepsis. Abnormal variability in size is termed anisocytosis; unusual variation in shape is called poikilocytosis; and significant differences among erythrocytes in the dilm of central pallor is referred to as anisochromia.

Uremia The presence of spur cells acanthocytes may indicate: Goldman L, Schafer AI, eds. Stomatocytes in a dog. Elevated cardiac markers Elevated alpha-fetoprotein. Acanthocyte seen with electron microscopy. Artifactual changes of erythrocytes occur commonly on peripheral blood films. Target cells in a dog. The spur cells acanthocytes of chronic alcoholic liver disease have increased cholesterol but, in contrast to target cells, normal content of phospholipids.

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Blood Smear

In patients with megaloblastic anemias the nucleated erythrocytes in the blood have megaloblastic nuclear features.

Abnormal clinical and laboratory findings for RBCs Histopathology. Hypochromia generally arises because of impaired hemoglobinization of erythroid cells in the marrow. Size Anisocytosis Macrocyte Microcyte. The formation of echinocytes can be determined by electric field pulses.

Granulocytes of blood anticoagulated with EDTA may acquire cytoplasmic vacuoles. As a result, they appear on routine blood films as cells that are smaller and more dense than normal red blood cells of the species, and have a reduced area of central pallor. Several echinocytes burr cells can be seen in the top image; three of them are indicated by the arrows.

This test may be performed as part of a general health exam to help diagnose many illnesses. What the risks are Veins and arteries vary in size from one patient to another and from one side of the body to the other. Reactive lymphocytes are usually larger than small lymphocytes, may have cytoplasmic vacuolization, sometimes have deep blue staining of the periphery of the cytoplasm, and contain nuclei that may be kidney bean or monocytoid in shape. The three disorders particularly associated with coarse basophilic stippling are lead poisoning, sideroblastic anemia, and thalassemia.

Poikilocytosis induced by doxorubicin. Retrieved from ” https: Usually seen in relatively low numbers, they are associated with conditions in which the normally smooth endothelial lining is roughened or irregular, the vascular lumen is crossed by strands of fibrin, or blood flow is turbulent.


Moderate to marked spherocytosis is diagnostic of immune-mediated hemolytic anemia IMHA. Agglutination of red cells on the slide is usually due to cold agglutinins. Stomatocytes can also be an artifact in a blood smear that is too thick.

Note that when the thin membrane of the eccentrocyte is removed or ruptures, a small cell which lacks central pallor is formed. MyChart Find a Doctor. An occasional elliptical or oval erythrocyte may be seen as a non-specific finding in a variety of settings.

Blood Smear | Medical Tests | UCSF Benioff Children’s Hospital

Leptocytes or wafer cells are thin, flat cells with the hemoglobin at the periphery of the cell. The History, Physical, and Laboratory Examinations.

Stomatocytes are erythrocytes with an elongated mouth-like area of central pallor. Leptocytes are seen in thalassemic disorders and with obstructive liver disease. Some labs use different measurements or test different samples.

Leukocytes may rupture during the preparation of the blood film, leaving amorphous nuclear material “basket” cells. Alternative Names Peripheral smear How the test is performed A blood sample is needed.

Although platelets usually occur singly on the blood film, in some cases there is considerable aggregation of platelets, making estimation of the number of platelets more difficult. Round erythrocytes with a single, elliptical or round surface defect are termed bite cells. Spiculated cells echinocytes and acanthocytes and target cells. Echinocytes in freshly-collected blood from a horse with colic. Morphologic identification of inclusion bodies within erythrocytes can be helpful clinically.

Schistocytesor red blood cell fragments, are generally taken to reflect mechanical injury to erythrocytes. Erythrocytes are slightly smaller than small lymphocytes. Low numbers of keratocytes may be seen in various situations and may not have any clear clinical significance e. Echinocytes, or crenated red blood cells, in contrast, have shorter, usually sharp blunt spicules of uniform length which are more evenly spaced around their periphery.