Haematology notes detailing haematological pathologies and conditions. Notes made from multiple resources such as oxford handbook, question banks, university lectures and UK guidelines.
Look at specialty section and content list for the summary contents of this file.
Description
Many haematological diagnoses are made by careful examination of the peripheral blood film. Differential cell counts
can be used to diagnose certain disorders.
Important Cells on Peripheral Blood Film
Target (Mexican hat) cells Howell-Jolly Bodies
- Path: Stained centre + edge with a central pallor ring - Path: DNA nuclear remnants seen in RBCs
- Cx: LD; Hyposplenism; Thalassaemia; IDA - Cx: Splenectomy; Hyposplenism
Poikilocytosis Heinz Bodies
- Path: Variation in RBC shape - Path: Oxidative damage of haemoglobin
- Cx: IDA; Myelofibrosis; Thalassaemia - Cx: G6PD Deficiency; α-Thalassaemia
Pencil Poikilocytes Schistocytes (Helmet Cells)
- Path: Decreased RBC turnover or production - Path: Fragmented RBCs sliced by fibrin bands
- Cx: IDA; Hereditary elliptocytosis; Malaria - Cx: HUS; TTP; Pre-eclampsia
Tear-drop RBCs (Dacrocytes) - NB: Leads to intravascular haemolysis
- Path: Seen in extramedullary haematopoiesis Burr Cells (Echinocytes)
- Cx: HA; Thalassaemia; Myelofibrosis (squeezed out) - Path: RBC projections
Spherocytes - Cx: Pyruvate kinase deficiency; ↓ VitE; CKD
- Path: Spherical cells Acanthocytes
- Cx: Hereditary spherocytosis; AIHA - Path: Spicules on RBCs
Basophilic RBC Stippling - Cx: Splenectomy; Alcoholic LD; Spherocytosis
- Path: Denatured RNA found in RBCs
- Cx: Lead; Megaloblastic anaemia; Myelodysplasia; LD
- NB: Indicates accelerated erythropoiesis
Other Cells on Peripheral Blood Film
Blasts Left Shift
- Path: Nuclear precursor cells - Path: Immature neutrophils from marrow
- Cx: Leukaemia; Myelofibrosis; Malignant marrow - Cx: Infections
Cabot cells Leukoerythroblastic film
- Cx: Pernicious anaemia; Lead; Infections - Path: Immature cells ± tear drop RBCs
Dimorphic picture - Cx: Haemolysis; Marrow infiltration; Infection
- Path: Two populations of RBCs Pappenheimer bodies
- Cx: Transfusion; 1o Sideroblastic anaemia - Path: Granules of siderocytes containing iron
Rouleaux Formation - Cx: Lead; Post-splenectomy
- Path: RBCs stack on top of each other Polychromasia
- Cx: Chronic inflammation; Paraproteinemia; Myeloma - Path: RBCs of different ages stain unevenly
- NB: Leads to an increased ESR - Cx: Bleeding response; Haemolysis
Right shift Reticulocytes
- Path: Hypermature (Hypersegmented) white cells - Path: Young, larger RBCs (contain RNA)
- Cx: Megaloblastic; Uraemia; LD - Cx: Haemolysis; Haemorrhage; Supplements
Hypochromia - Ix: Requires azure blue + Cresyl blue staining
- Path: Less dense staining of RBCs - NB: Signifies active erythropoiesis
- Cx: IDA; Thalassaemia; Sideroblastic anaemia
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