Post on 22-Oct-2020
Indication of peripheral blood smear
exmination:1. For carried out differential WBC count.
2. For differential diagnosis of anemia.
3. For detection of parasites.
4. For diagnosis of leucemoid reaction.
5. For diagnosis and differential diagnosis of leukemia.
6. For detection of platelet abnormalities.
7. For diagnosis of conditions like infectious mononucleosis.
1) RBC series
2) WBC series
3) Platelets
4) Parasites
5) Other abnormal cells
final diagnosis with advice
1. Abnormalities of Haemoglobin content:-
HypochromiaHyperchromiaAnisochromiaPolychromatophilia
2. Abnormalities of size of red cells:-
MicrocytosisMacrocytosisAnisocytosis
3. Abnormalities of shape of red cells ( Poikilocytosis ):-
different abnormal shapes of RBC
I. Elliptocytosis
II. Spherocytosis
III. Target cells
IV. Schistocytosis
V. Acanthocytois
VI. Crenated cells
VII. Sickled cells
VIII. Leptocytes
4. Abnormalities of structure of red cells:-
•Basophilic stippling ( Punctate basophilia )
•Howell- jolly bodies
•Cabot rings
•Pappenheimer bodies
•Malarial stippling
•Rouleaux formation
•Agglutination
•Nucleated red cells
•No nucleus, enzyme packets•Biconcave discs – Haem + Gl•Center 1/3 pallor•Pink cytoplasm (Hb filled)•Cell size 7- 8 µ - capill. 2 µ•EM pathway, HMP•Negative charge – no phago•Na less, K more inside•100-120 days life span
Hypochromic Microcytic
The RBC‘s here are smaller than normal and have an increasedzone of central pallor. This is indicative of a hypochromic (less hemoglobin in each RBC) microcytic (smaller size of each RBC) anemia. There is also increased anisocytosis.
Microcytic
the average size of erythrocytes is smaller than normal
Macrocytic
Note the hypersegmented neurotrophil and also that the
RBC are almost as large as the lymphocyte. Finally, note
that there are fewer RBCs.
Here. Elliptocytosis,
Megaloblastic
anaemia
ELLIPTOCYTE
HS, AIHA, Thermal
injury,Burns,
Chemical poisoning,
Hypophosphataemia
SPHEROCYTE
Uraemia,Pyruvatekin
ase
defi.,Phosphoglycera
te kinase defi.
ECHINOCYTES
Disturbence in red
cell cation
composition
Hereditary
Stomatocytosis, Liver
disease, Alcoholism
STOMATOCYTE
Thalassemia Major,
Microangiopathic
Hemolytic anaemia,
Cardiac Hemolytic
anaemia
Sickle cell anemia
Thalassemia
disorder, Sickle cell
anaemia, Hb E & Hb
C disease,Liver
disease, after
splenectomy
Terminology Description Condition
Target cells Central hemoglobin; target-shaped Liver disease; thalassemia: Abnormal
Hgb; iron deficiency
Echinocyte Short spicules, equally-spaced Uremia, hypokalemia, artifact
Acanthocyte Spiculated, irregular Liver disease (alcohol), Post-splenectomy
Spherocyte Spherical, no central pallor HS, Immune hemolytic anemia
Schistocyte Fragmented RBC, helmet cells MAHA, burns
Ovalocyte Oval/elliptical shaped Hereditary elliptocytosis, Megaloblastic anemia
Sickle cell bipolar spiculated shape Hgb S-containing “banana” shaped hemoglobinopathy
Teardrop cell single elongated extremity Myelophthistic changes
Bite cells Irregular gap in membrane G6PD deficiency
Rouleaux formation Stacking of
RBCs due to
increased plasma proteins coating RBCs
Agglutination Antibody-mediated
clumping,
temperature mediated
Auto immune
hemolytic anaemia
NORMOCYTIC NORMOCHROMIC RBC
MICROCYTIC HYPOCHROMIC RBC
G6PD Deficiency
Microcytic -Thalassaemia trait
Normocytic - Lead poisoning
Normo or micro -Sideroblastic anemia
Macrocytic -Megaloblastic anemia
Post splenectomy
Splenic atrophy
Pernicious anaemia
Coeliac disease
RING OF P.VIVAX
TROPHOZOITE OF P.VIVAX
MULTIPLE RINGS OF P.FALCI
GAMATOCYTE OF P.FALCI
Cells with 5 or more
lobes are considered
hypersegmented, e.g.
megaloblastic
changes
Uraemia
After cytotoxic drug
treatment esp
methotrexate
BLAST CELL
Thank You Thank You
MYELOCYTE
BASOPHIL
MYELOBLAST
Platelets are small, 1-3 µm in diameter,
purple structures with tiny irregular
projection on surface.
Thrombocytopenia in malaria and dengue.
Causes of false thrombocytopenia on automated heamatology analyzer:
a)
Clumps of platelets Platelet satellitism.