IDENTIFICATION OF NORMAL AND ABNORMAL FORMS OF RED BLOOD CELLS

Prepared by: Miss. Nada Alzahrani

Erythrocytes (RBCs)

The normal RBCs are biconcave discs, anucleate, essentially no organelles

Filled with hemoglobin (Hb), a protein that functions in O2 and Co2 transport

Contain the plasma membrane protein spectrin and other proteins that: Give erythrocytes their flexibility Allow them to change shape as necessary

Erythrocytes (RBCs)

The Morphological classification

The morphological classification of RBC is

based on:

red cell size.

red cell shape.

haemoglobin content of RBC.

red cell with inclusions.

1. Red Cell Size:

Red Cell Size:

1. microcytes: MCV < 80 fL

2. normocytes: MCV = (80 – 98) fL

3. macrocytes: MCV > 98 fL

4. anisocytosis: variation in red

cell size.

Haemoglobin Content of RBC

Haemoglobin Content of RBC : 1. Hypochromic cell: reduced

staining of erythrocytes. 2. Normochromic cell: normally

staining (of a red cell). 3. Polychromatic cell: an erythrocyte

with a blue tinge to the cytoplasm, indicating

that it is a young red cell.

The Morphological classification

Red cell size and haemoglobin content are

classified into 3 types:

I. Microcytic, hypochromic

II. Normocytic, normochromic

III. Macrocytic, polychromatic

Microcytic Hypochromic

Causes:

Iron deficiency anemia

Thalassemia minor

Anemia of chronic disease

Congenital sideroblastic anemia

ß-Thalassemia intermedia and major

Hemoglobin H or E disease

Microcytic Hypochromic

Normocytic Normochromic

Causes :

Anemia of chronic disease

Early iron deficiency

Renal failure

Aplastic anemia

Leukemia

Lymphoma

Cancer

Macrocytic Polychromatic

The RBC are almost as large as the lymphocyte.

Causes:

Megaloblastic anemia.

Alcoholism

Liver disease

Reticulocytosis

Chemotherapy

Multiple myeloma

Hypothyroidism

Macrocytic Hypochromic

Red Cell Shape

1.Acanthocytes

Cells with irregular, thorny

speculated membrane

surface projections bulbous

round ends.

Red Cell Shape

2. Ecchinocytes:

Cells with 10-30

uniformly distributed

spicules.

Red Cell Shape

3. Elliptocytes:

Red blood cells

that are oval or

cigar shaped.

Red Cell Shape

4.Spherocytes,:

Spherocytes are almost spherical in shape. They are not biconcave like a normal red blood cell and do not have the central area of pallor which a normal red cell shows.

Red Cell Shape

5. Target cells:

are abnormally thin erythrocytes that when stained show a dark central color spot in the area of pallor and a peripheral ring of hemoglobin, separated by a pale unstained ring containing less hemoglobin.

Red Cell Shape

6. Tear Drop cells:

An abnormal erythrocyte shaped like a teardrop.

Red Cell Shape

7. Stomatocytes

cells are cup shaped with an abnormal area of central pallor that may be oval, elongated, or slit like

Red Cell Shape

8. Sickle Cells

Cells have a sickle with appoint at one end.

Red Cell Shape

9. Schistocytes :

are red blood cell fragments that result from membrane damage encountered during passage through vessels.

Red Cell Shape

10. Rouleaux

formation:

Occurs when

RBCs form

stacks or

rolls.

 

Red Cell Shape

11. Poikilocyte :

an abnormally shaped erythrocyte.

(increased variability in the shape of erythrocytes).

Red Cell with Inclusions

Red Cell with Inclusions:

1. Basophilic stippling. 2. Heinz bodies 3. Howell jolly body 4. Nucleated RBC 5. Malaria parasites 6. Reticulocyte.

Red Cell with Inclusions

1. Basophilic stippling:

The presence of evenly dispersed purplish blue dots in the cytoplasm of erythrocytes.

Red Cell with Inclusions

2. Heinz bodies :

are denatured particles of haemoglobin attached to RBC membrane that appear when stained with cresyl blue or methyl violet.

Red Cell with Inclusions

3. Howell jolly body :

are nuclear fragment found in red cells, mostly single but sometimes multiple.

Red Cell with Inclusions

4. Nucleated RBC:

The

erythroblasts

in the

circulating

blood

(immature red

cells).

Red Cell with Inclusions

5. Malaria

parasites:

1. P. falciparum

2. P. vivax

3. P. ovale

4. P. malaria

Red Cell with Inclusions

6. Reticulocyte:

a young erythrocyte, newly released form the bone marrow, identified by its uptake of certain vital stains such as new methylene blue.

Reticulocyte

Blood Smear Interpretation:

A) Normal

B) Micro/hypo

C) Macro

D) Target

E) Sphero

F) Heinz body

G) Schistocyte

H) nRBC

I) Polychrom

J) Teardrop

A B C D

E F G H

I J

Thank you