Identification Of Normal And Abnormal Forms Of Red

IDENTIFICATION OF NORMAL AND ABNORMAL FORMS OF RED BLOOD CELLS

Prepared by: Miss. Nada Alzahrani

Erythrocytes (RBCs) 

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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.

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red cell shape.

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haemoglobin content of RBC.

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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

The Morphological classification Red cell size and haemoglobin content are classified into 3 types: 

I. Microcytic, hypochromic

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II. Normocytic, normochromic

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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

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

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

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 erythrocyte

Red Cell with Inclusions 

Red Cell with Inclusions: 1. Basophilic stippling.

2. 3. 4. 5. 6.

Heinz bodies Howell jolly body Nucleated RBC Malaria parasites 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

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: 3. P. falciparu m 4. P. vivax 5. P. ovale 6. P. malaria

Red Cell with Inclusions 6. Reticulocyte : a young erythrocyte, newly released form the bone marrow, identified by its uptake of certain vital

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

E

I

B

F

J

C

D

G

H

Thank you