Some cells have a similar physical appearance, so staining differences can help identify different cells. Most of these neutrophilic changes originate in the cytoplasm in response to various pathologic processes. Abnormal morphology of white blood cell white blood cells may exhibit several morphological changes, and the neutrophils are the cell type primarily affected. Abnormal morphology of blood cells april 2012 hematologyimmunology system faculty of medicine universitas padjadjaran. The red blood cells get trapped in the fibrin strands and the sheer force of the blood flow causes the red blood cell to break.
This condition is reversible, and more often than not, it is a side effect of the edta anticoagulant coating in the vacutainer used to collect to blood to prevent it from clotting. The red cell mcv is measured directly on cell counters. Any deviation in size, shape, and staining properties represents abnormal red cells. Ce hours for laboratory continuing education with medialabs red cell morphology courses. Acetylsalicylic acid and morphology of red blood cells article pdf available in brazilian archives of biology and technology 533. Important preliminary findings include agglutination, polychromasia reticulocytosis, target cells liver disease or alcohol, and a dual population mds or post transfusion. In this study, red cells were isolated from fresh blood or bone marrow samples only from newly diagnosed patients who had not undergone any chemoradio therapy indicating the absence of any changes in the red cell ultrastructure and morphology due to aging or the treatment of any chemotherapeutic drugs. Red blood cell morphology questions and study guide. The proposed study aims at morphologybased detection of abnormal red blood cells in peripheral blood smear images, based on their size and shapes. Red blood cells are the major cellular component of blood. However, variable abnormal erythrocyte morphology is found in various pathological conditions.
Describe the main cell types observed in peripheral blood. The primary function of red blood cells is to transport oxygen to body cells. Mature red blood cells are biconcave discs that lack nucleus and most cell organelles such as lysomes, endoplasmic reticulum and mitochondria. Lesson assignment lesson 4 morphology of blood cells. Morphologic abnormalities in red cell size, shape, and color are discussed and numerous photomicrographs are included. Red cell morphology in leukemia, hypoplastic anemia and. Reporting and grading of abnormal red blood cell morphology. This normal morphology is indicated by the term normochromic. Blood, morphology, rbc, platelets, wbc summary these guidelines provide information on how to reliably and consistently report abnormal red blood cells, white blood cells and platelets using manual microscopy. Change in hematological parameters and red blood cell morphology indicates enhanced red blood cell pathology. Because of a high prevalence of the coinheritance of thalassemia and g6pd deficiency 10% in the thai population, detection of this coinheritance in the suspected individuals will reduce the risk of hemolytic anemia, as red blood. Blood cell morphology tutorial lsu school of medicine. Often slightly larger than normal red cells and round in shape round macrocytosis. In wellspread, dried and stained films the great majority of cells have round, smooth contours and diameters within the comparatively narrow range of 6.
Blood cell morphology in health and disease clinical gate. In normal red blood cells, there is an area of central pallor that measures approximately the diameter of the cell. Red blood cell morphology, anemia, peripheral blood examination. Interpretation of red blood cell morphology advanced. Morphology based detection of abnormal red blood cells in. Abnormalities such as anisocytosis, macrocytosis and microcytosis are detected based on the size of the rbcs. The morphology of red blood cells and white blood cells should be normal. In patients with microcytic anemia, rbc morphology can increase or decrease. It brilliantly illustrates an even broader spectrum of morphologic variation in red and white blood cells. These cells will display a central pallor no larger than 3 microns in diameter.
Therefore, as with polychromasia in image abi08, it is not unexpected to see target cells in this case study patient. Red blood cells, also called erythrocytes, are the most abundant cell type in the blood. In health, the red blood cells vary relatively little in size and shape. They are thus very common in hemolytic anemias, obviously since rbcs are hemolysed and broken down in this condition. Get a printable copy pdf file of the complete article 233k, or click on a page image below to browse page by page. The counter is able to plot a red cell volume histogram, and the mean is determined. It is limited to the material covered in the lectures and laboratory sessions. Morphology of blood cells blood body fluids biology. We have conducted experiments in vitro using venous red cells which indicate that hypochromia depends mainly upon sodium concentration and occurs when this falls below 75 mmoll.
Grading guide is a reference guide for grading red blood cell abnormalities, white blood cell abnormalities, and platelet morphology. Red blood cell morphology usually plays a small but important role in this differentiation of megaloblastic from nonmegaloblastic causes. Other major blood components include plasma, white blood cells, and platelets. The erythrocytes are the most numerous blood cells i. The nomenclature used to describe red blood cells is recommended by the american. Morphology parameters suggest that significant alterations to rbc morphology over storage duration occur soon after the 14th day of storage, as to become. Guidelines for reporting red blood cell morphology. Define and explain red cell indices including derived values such as mcv, mchc and mch 3. Before we start with the abnormal morphologies, lets talk about normal morphology of red blood cells. The rbc in image abi10 has inclusions called pappenheimer bodies.
Learn vocabulary, terms, and more with flashcards, games, and other study tools. Grading guide by gene gulati, 96 pp with illus, chicago, illinois, american society for clinical pathology press, 2009. Normal mature rbc are biconcave, round discs that are about 6 8 in diameter, which is only slightly smaller than the normal small mature lymphocytes about 6 10 in diameter. Pdf red blood cell storage and cell morphology researchgate. Tutorial blood cell morphology a clinical pathology 201. The resulting fragmented cell is called the schistocyte. Some of these changes can be pathologic in one context or in one species or physiologic in another. Unfortunately the front cover is the only picture with color and everything within is black and white. Summary of abnormal red blood cell morphologies and. Red blood cell morphological abnormalities youtube. Morphological abnormalities of red blood cells the art.
Define and explain erythrocyte sedimentation rate 4. Malaria and human red blood cells pubmed central pmc. Discuss various aspects of red cell morphology related to cell shape. Iron deficiency thalassemia syndromes sideroblastic anemia. Discuss the procedure for proper red blood cell examination with respect to. This light microscopy smear showed that most of the red blood cells have a changed morphology. In macrocytic anemias, rbc morphology can help guide the. Evaluation and interpretation of red blood cell rbc morphology is an important component of a complete blood count cbc. Although red cell morphology has been used to localise the site of haematuria in the urinary tract, the cause of red cell deformity is still speculative. Abnormal morphology of red blood cell when a blood smear is inspected for abnormal morphology, two criteria must be met. Pdf acetylsalicylic acid and morphology of red blood cells.
While the descriptions are good, the most important thing is color pictures for the entry level tech to study for manual differentials. For example, small heinz bodies are commonly seen in the blood of cats without causing anemia. Red blood cell inclusions and abnormalities hematology. Rbc morphology reporting per high power field 400x few. Scanning electron microscopy, by which high magnifications of the red blood cells can be viewed, showed that the cells form. Describe what is meant by the term differential count.
How do you differentiate leukoblasts wbc and proerythroblasts rbc. Echinocytes are red blood cells with abnormal cell membranes that cause them to appear spiked or like a sea urchin. The effect of iron overload on red blood cell morphology. In patients with anemia, the peripheral smear permits interpretation of diagnostically significant red blood cell rbc findings. The functional lifetime of a red blood cell is about 100120 days, during which time the red blood cells are continually moved by the blood flow push in arteries, pull in veins and a combination of the two as they squeeze through microvessels such as. There are also changes that occur in red blood cells that can give us clues as to underlying diseases. Blood morphology ask hematologist understand hematology. Grading of abnormal cells, nomenclature and a brief description of the cells are provided. In younger patients with itp, the disease usually remits spontaneously within several weeks and no treatment is usually required unless there is significant bleeding.
This cell development is a gradual transition as noted in ascp terminologythey are listed from the most immature to mature cells and six different stages can be identified. Unfortunately, a few cell illustrations are not available at this time but will be added later. Mature red blood cells, under normal circumstances, will also have an appropriate hemoglobin content, giving them a redorange appearance on wrightstained smears. Full text full text is available as a scanned copy of the original print version. Hematological parameters and red blood cell morphological. They are seen especially in syndromes of microangiopathic. Rbc morphology may provide important diagnostic information regarding the underlying cause of anemia and systemic disease. This is a video describing various morphological abnormalities found in red blood cells, including changes in red cell size, shape, color, and distribution. Schistocytesfragments are small pieces fragments of red cells with irregular outline characterized by triangular, crescentic, and halfmoonshaped cells.
Guidelines for reporting red blood cell morphology labce. In man and in all mammals, erythrocytes are devoid of a nucleus and have the shape of a biconcave lens. Red blood cell storage and cell morphology 93 storage 42 days, haemolysis was lower than the 0 8% threshold for all the tested subjects 0 34 0 1 fig. The presentation of illustrative cells in this module is by no means a comprehensive study of blood cells. Red blood cell, cellular component of blood that carries oxygen from the lungs to the tissues and gives vertebrates blood its characteristic color. Red cells stain shades of bluegray as a consequence of uptake of both eosin by haemoglobin and basic dyes by residual ribosomal rna. Red blood cell morphology, grading system, standardization summary in spite of the continual standardization of test result formats, the improvements of laboratory technologies, publications of reference guidelines, and the advancements in hematology analyzers, the methods of reporting or grading abnormal red blood cell morphol. The availability of the complete sequence of the malaria parasite genomes and the establishment of a transfection system for the red blood cell stages of p. Summary of abnormal red blood cell morphologies and disease states. What makes red cells dysmorphic in glomerular haematuria.
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