BANCIL, ALLEN IRA R.

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RED BLOOD CELL MORPHOLOGIES AND THEIR ASSOCIATED CAUSES & DISEASES

RBC MORPHOLOGY ILLUSTRATION CELL DESCRIPTION CAUSE/DEFECT ASSOCIATED DISEASES

1. Acanthocyte Mature red blood cell, Inherited lipid disorder, Associated hemolytic
spherical and densely stained alcoholic cirrhosis, anemia,
cell with 3-12 spicules of malabsorption states, neonatal Abetalipoproteinemia,
uneven length and width hepatitis, pyruvate kinase Hepatic hemangioma.
around the surface. deficiency.

2. Codocyte (Target Cell) Mature red blood cell, bell Obstructive Liver disease, Hemoglobinopathies: Hb C
shaped with thin wall having a Iron deficiency, disease, Sickle Cell
greater than normal surface Postsplenectomy, Thalassemia, Hemolytic
membrane to volume ratio; Artifacts anemias
central area of hemoglobin
with a bull’s eye appearance.

3. Dacryocyte (Teardrop Mature red blood cell, Extramedullary hematopoiesis, Myelophthisic anemia,
Cell) pear-shaped with blunt Hypersplenism Megaloblastic anemia,
pointed projections Thalassemia

4. Degmacyte (Bite Cell) Mature red blood cell, has a Unstable hemoglobinopathies Glucose-6-phosphate
semicircular area of cell dehydrogenase deficiency,
removed by spleen with Thalassemia,
peripheral defects. Drug-induced anemias

5. Drepanocyte (Sickle Mature red blood cells, Hemoglobinopathies (SS, SC, Sickle cell anemia,
Cell) elongated due to polymers of SD, S-B thalassemia) ABO hemolytic disease of
abnormal hemoglobin, lacking the newborn
a central pallor.

6. Echinocyte (Burr Cell) Mature red blood cells with Slow drying, renal insufficiency, Anemias, bleeding gastric
evenly distributed, short Pyruvate kinase deficiency, ulcers, gastric carcinoma,
spicules with a blunt end with severe dehydration, burns peptic ulcers, uremia
central pallor.

REFERENCES:
- Turgeon, M. (2005). Clinical Hematology Theory and Procedures 4th Edition. Page 102 (Part 2 Erythrocytes; Table 6.2)
- Young, S., et. al. (2001). Anderson’s Atlas of Hematology Third Edition. Pages 27-53
 BANCIL, ALLEN IRA R.
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7. Keratocyte (Horn Cell) Mature red blood cells with Glomerulonephritis, pyruvate Microangiopathic hemolytic
projections that resemble kinase deficiency anemia, Waring blender
horns. syndrome

8. Knizocyte (Pinch Cell) Mature red blood cells with Hemoglobinopathies Hemolytic anemia
triconcave shape having two Pancreatitis
central pallors.

9. Ovalocyte (Elliptocyte) Mature red blood cells with an Hb C Disease Hereditary elliptocytosis,
oval-shape, hemoglobin are Sickle cell trait Congenital
concentrated at two ends with dyserythropoietic anemia,
normal central pallor. Malignant-associated
anemias

10. Rouleaux Mature red blood cells that Increased fibrinogen Hyperproteinemia
are stacked (3 or 4 or more) Multiple myeloma
resembling coins with a Macroglobulinemia
blue-staining background.

11. Pyknocyte (Blister Cell) Mature red blood cells with Microangiopathic hemolytic Infantile pyknocytosis
clearing on one side and anemia Infantile viremia
concentrated area of Pulmonary emboli in sickle cell
hemoglobin on the other. anemia

12. Schistocyte (Schizoyte) Mature red blood cells with an Damaged membrane Microangiopathic hemolytic
irregular shape or fragment of Trauma anemias, Traumatic
cell resulting from damaged Burns hemolytic anemias, Waring
membrane. Prosthetic implants blender syndrome

REFERENCES:
- Turgeon, M. (2005). Clinical Hematology Theory and Procedures 4th Edition. Page 102 (Part 2 Erythrocytes; Table 6.2)
- Young, S., et. al. (2001). Anderson’s Atlas of Hematology Third Edition. Pages 27-53

13. Spherocyte Mature red blood cells,
6.1-7µm in size, round with
increased staining intensity
with no central pallor and
having smaller volume than
normal.
14. Stomatocyte Mature red blood cells with a
slit-like area of central pallor.
15. Macrocyte Mature red blood cells,
>7.8µm in size, large with an
MCV >100fL, normochromic,
may be round or oval.
16. Microcyte Mature red blood cells,
<6.5µm in size, large with an
MCV <80 fL, normochromic or
hypochromic
17. Dimorphic Mature erythrocytes, size
varies between 6-11µm, dual
population of cells =
normocytic and microcytic;
normocytic and macrocytic.
18. Hypochromic Mature red blood cell, cells
possess a greater central
pallor than normal (more than
1/3), may lack hemoglobin
and have a decreased MCHC
REFERENCES:
- Turgeon, M. (2005). Clinical Hematology Theory and Procedures 4th Edition. Page 102 (Part 2 Erythrocytes; Table 6.2)
- Young, S., et. al. (2001). Anderson’s Atlas of Hematology Third Edition. Pages 27-53
BANCIL, ALLEN IRA R.
Severe burns
Hereditary spherocytosis
Alcoholism
Obstructive liver disease
Hereditary stomatocytosis
Acute blood loss
Chemotherapy
Lead poisoning
RBC transfusions
Myelodysplastic syndromes
Iron deficiency
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Immunohemolytic anemias,
Heinz body hemolytic
anemia.
Rh-null disease
Cirrhosis
Liver disease
Megaloblastic anemia
Myelodysplastic syndromes
Iron deficiency anemia,
thalassemias, Anemia of
chronic disease,
Sideroblastic anemia
Sideroblastic anemia
Myelodysplastic syndromes
Iron deficiency anemia
Thalassemia
Anemia of chronic disease
Sideroblastic anemia

19. Polychromatophilic Young red blood cell with no
nucleus, 8-11µm in size,
contains residual RNA which
stains diffusely blue (identified
as reticulocytes when stained)
20. Basophilic Stippling Mature red blood cell with
(Punctuate Basophilia) coarse, deep blue inclusions;
irregularly aggregated or
clumped ribosomes
throughout the cell.
21. Cabot Ring Mature red blood cell, oval or
figure of 8-shaped inclusion,
red-violet in color, usually one
per cell.
22. Heinz Bodies Young and mature red blood
cells, 1-2µm in size, round
refractile inclusions found on
the periphery of the cell when
stained with a supravital dye.
23. Howell-Jolly Body Round fragments of nucleus
(DNA), reddish-blue to deep
purple in color, usually one
per cell but occasionally may
be two or more.
24. Pappenheimer Body Small, irregular, pale blue to
dark staining granules,
usually found on the periphery
of cells and in groups; smaller
than Howell-Jolly bodies.
REFERENCES:
- Turgeon, M. (2005). Clinical Hematology Theory and Procedures 4th Edition. Page 102 (Part 2 Erythrocytes; Table 6.2)
- Young, S., et. al. (2001). Anderson’s Atlas of Hematology Third Edition. Pages 27-53
BANCIL, ALLEN IRA R.
Increased erythrocyte
production,
Membrane disorders
Altered hemoglobin
biosynthesis, Lead intoxication,
Alcoholism
Dyserythropoiesis
Unstable hemoglobinopathies
Alcoholism
Splenectomized persons
Hyposplenism
Disturbed hemoglobin
synthesis
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Hemolytic anemias
Hemolytic disease of the
newborn
Thalassemia, Megaloblastic
anemia, Sideroblastic
anemia,
Pyrimidine-5-nucleotidase
deficiency.
Severe anemias
Drug-induced anemias
Thalassemia
Glucose-6-phosphate
dehydrogenase deficiency
Megaloblastic anemia
Hemolytic anemias
Sickle cell anemia
Sideroblastic anemia
Dyserythropoietic anemias
Thalassemia
Myelodysplastic syndromes