Morphologic Evaluation of Meibomian Glands Using Noncontact Infrared Meibography
7 Morphologic Evaluation of Erythrocytes
Transcript of 7 Morphologic Evaluation of Erythrocytes
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MORPHOLOGIC
EVALUATION OF
ERYTHROCYTES
DISTRIBUTION
MORPHOLOGY
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DISTRIBUTION OF
RBCjNORMAL DISTRIBUTIONAttributed to the maintenance of the
zeta potential
Cells repel one another
Freely move in the blood vessels
jABNORMAL DISTRIBUTIONRouleaux formation
Agglutination
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jROULEAUX
FORMATION
Stacks of coins orstacks of plates
Occurs due toincrease of plasmagamma globulin
Hyperproteinemia Multiple myeloma
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jAGGLUTINATION
Cells aggregate inrandom clusters or
masses Due to the presence of
plasma agglutinins
Hemolytic anemia
Atypical pneumonia Staphylococcal infection
Cold agglutinin disease
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MORPHOLOGY OF
RBCj NORMAL MORPHOLOGY Biconcave (discocyte)
Round w/ central pallor (non-nucleated)
Central pallor (1/3 of the cells dm)
diameter 7-8m; thickness 2.5m
stain red to pink (Wrights stain)
j ABNORMAL MORPHOLOGY
Hgb Content, Size, Shape, Inclusion bodies
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Abnormal Morphology
jHEMOGLOBIN CONTENT
Normochromic
Hypochromic Larger central pallor
Hyperchromic
Lack central pallor
Anisochromasia
2 different cell population is present
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jSIZE (ANISOCYTOSIS)
Variation in RBC population size (asto cell volume rather than diameter)
NORMOCYTIC 80-100 fL
MACROCYTIC
>100 fL; Vit B12 deficiency
MICROCYTIC
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jSHAPE (POIKILOCYTOSIS)
Variation in shape poikilocytes
Due to:
Developmental macrocytosis
Membrane abnormality
Trauma
Abnormal hemoglobin content
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Developmental
MacrocytosisjOVAL
MACROCYTES
Due to Vitamin B12or Folate Deficiency
Vit B12 and Folateare essential for thesynthesis of purines
and pyrimidines
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Membrane AbnormalityjSPHEROCYTES
Round cellslacking centralpallor
Appear smallerthan RBC
Due to SPECTRINDEFICIENCY
HereditarySpherocytosis
AHA
Physical orChemical Injury to
the cells
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jELLIPTOCYTES
Hemoglobin areconcentrated atthe ends of thecells
Due to defective
CYTOSKELETON
Hemolytic Anemias
IDA
Myeloidfibrosiswith myeloidmetaplasia
Megaloblasticanemias
Sickle cell anemia
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jECHINOCYTES
known as CRENATED cell
echinos: sea urchin
Have evenly distributed,uniform-sized spicules orprojections
Due to ANTICOAGULANTused during blood
collection orhyperosmolarity
In vivo, decreased ATP
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jBURR CELLS
Have irregularly sizedknobby projections
Produced by therupture of the cellmembrane byenlarged vacuoles
Dx Implication:Renal Disease
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jACANTHOCYTES
Also known as SPURCELLS
acantho: thorn or spike Irregularly spiculated
cells in which ends of thespicules are bulbous androunded
Due to changes in theRATIOOF PLASMA LIPIDS Abetalipoproteinemia
Liver disease
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jSTOMATOCYTES
From stoma: mouth
Mouth-like or slit-like
area of the central pallor
Due to HIGHNa+ &LOWK+ content of the cell
Cell takes up more fluid
than usual squeezing thecentral pallor in the process
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jCODOCYTES
Also known as TARGET
CELLS; LEPTOCYTES From kodon: bell
Central area ofHemoglobin issurrounded by colorless
ring Appear like a BELL or aMEXICANHAT
Due to loading ofCHOLESTEROL and
PHOSPHOLIPID Obstructive Jaundice
Postsplenectomy state
Thalassemias
Hemoglobin diseases
Hypochromic anemias
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Due to Trauma
jSCHISTOCYTES
schisto: cloven or schizo: split
Cells are caught up in the SPLEEN Fragmented RBCs (helmet, triangular)
Indicate the presence of hemolysis
Megaloblastic anemia Severe burns
Microangiopathic anemia
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jKERATOCYTESAlso known asBLISTERCELL
Presence of vacuole-
like area
Schizocytes w/ 1 ormore projections
Caught up on aFIBRINSTRAND
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jDACRYOCYTES
Also known as TEARDROP CELL
From dakry: tear
Pear-shaped cell w/ blunt pointedprojection
Caught up in FIBRIN
Associated w/H
einzBodies
Seen in cases ofMyelofibrosis andtuberculosis
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jMICROSPHEROCYTES
Also known as PYROPOIKILOCYTES
Tiny, round, fragmented cells
Due to altered SPECTRINcontent
jSEMILUNAR BODIES
Also known: HALF-MOON/CRESCENT CELL
Red Blood Cell ghost
Due to infection with MALARIA
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Abnormal Hemoglobin
ContentjDREPANOCYTES
Also known as SICKLE CELL
From drepane: sickleThin and elongated
Due to the presence ofHb S
Hb CC &Hb SC
Appearance ofTarget Cell
Condensation ofHb crystals
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jINCLUSIONS
Granulation found in the cytoplasm ofRed Blood Cell
Due to:
Developmental organelles
Abnormal Hemoglobin Precipitation
Protozoan Inclusion
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Developmental Organelles
jHOWELL-JOLLY BODIES
Small, roundremnants/fragments of
nuclear chromatin Due to incomplete extrusion
of nucleus during maturation
Seen in:
Megaloblastic anemiaHemolytic anemia
After splenectomy
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jBASOPHILIC
STIPPLING
Fine or coarse, deep
blue to purplestaining inclusion
Aggregates ofribosomes
Due to lead or
arsenic intoxication Seen in megaloblas-
tic anemia
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jPAPPENHEIMER
BODIES
Siderotic granules
(excess amount of iron store)
Small, irregular,dark-staining
Appear near the
periphery of nRBC Positive for PERLSPRUSSIANBLUE
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jPOLYCHROMATOPHILIC RBC
Are diffusely basophilic RBC
H
aveNO
nucleus but still containRN
A Indicative of young form
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jCABOT RINGS
Thin, ring-likestructure
Figure-of-eight orloop-shaped
Rings areprobably
microtubulesremaining from amitotic spindle
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Abnormal Hgb
PrecipitationjHEINZ BODIES Round, refractile
inclusion
Are denatured globin Stain w/ supravital
stains: crystal violet, methylene
blue, brilliant cresyl blue
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jHGB H INCLUSION
Small, greenish-blue inclusion
D
ue to failure to synthesize alphaglobin chain
Stains w/ 1% BCB
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Protozoan Inclusion
jMALARIA
P. vivax(SCHUFFNERS DOTS)
P. ovaleP. malariae (ZEIMANNS DOTS)
P. falciparum (MAURERS DOTS)
jBABESIA
Babesia microti
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P. vivax
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P. ovale
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P. malariae
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P. falciparum