HemOnc Peripheal Blood Morphology

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RBC normal size

size of a lymphocyte nucleus

Anisocytosis

RBC which vary widely in size

microcytosis

RBCs that are small. can use lymphocyte nucleus for comparison

3 causes of microcytosis

(1) iron deficiency (2) thalassemia (3) sideroblastic anemia

macrocytosis

large RBCs

6 causes of macrocytosis

(1)high reticulocyte num (2) B12/ folate def (3)liver disease (4)thyroid disease (5)chemo (6)AZT

hypochromasia

RBC that have too little hemoglobin. area of central paller greater than 1/3 total diameter

how to measure hypochromasia

MCH

Polychromasia

RBC that have more of a bluish tinge. are larger and prob reticulocytes

Polikilocytosis

RBC vary widely in shape

Target cells

look like bulls-eyes

4 causes of Target cells

(1) liver diease (2) thalassemias (3) hemoglobin c (4) after splenectomy

Spherocytes

RBCs lose central pallor

2 causes of Spherocytes

(1) hereditary spherocytosis (2) autoimmune hemolysis

Schistocytes

RBC fragments with sharp edges

cause of schistocytes

Microangiopathic Hemolytic Anemia

Echinocytes (burr cells)

have small regular projections

cause of echinocytes

renal disease

acanthocytes (spur cells)

have larger irregular projections

cause of acanthocytes

liver diease

Teardrop cells

seen in myelophthisic processes (marrow infiltration diseases)

4 causes of teardrop cells

(1) Myelofibrosis (2)tumor mtastic to marrow (3)granulomatous diease (4) leukemia and lymphomas

Howell-Jolly Bodies

some round purple inclusions in RBCs. are nuclear remnants

Cause of Howell-Jolly Bodies

seen after splenectomy or in spenic hypofunction

Rouleaux

linear arrangments of RBCs

causes of Rouleaux

high Ig (1) multiple myeloma (2) Waldenstrom's mcroglobulinemia (3) hypoalbuminemia

agglutination

occurs when RBCs are coated with IgM

Iron Deficiency Anemia presentation

hypochromic, microcytic cells. high platelet numbers

Betha Thalassemia major presentation

(1) target cells (2) howell-jolly body (3) Nucleated red cell (4) schistocyte (5) basophilic stippling

Megaloblastic anemia presentation

macrocytic RBCs. Hypersegmented neutrophils

cause of hypersegmented neutrophils

Megaloblastic anemia

Autoimmune Hemolytic Anemia (AIHA)

polychromasia microspherocytes

Components of CBC

hemoglobin, hematocrit, WBC, RBC, platelets, MCV, MCH, MCHC, RDW

MCV

average size of RBC. Indicates microcytosis (SIT) or macrocytosis (MAC BELT)

MCH

amound of hemoglobin in RBC. can indicate Hypochromasia

MCHC

hemoglobin concentration

RDW

RBC distribution width. indicates Anisocytosis

normal MCV value

80-100

normal reticulocyte level

5-10%

microshperocytes

due to autoimmune hemolysis

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