By Irma Pereira MT (ASCP) SH, Tracy I. George MD, Daniel A. Arber MD
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Additional info for Atlas of Peripheral Blood: The Primary Diagnostic Tool
RBC Hemoglobin Concentration: Normal RBCs have central pallor that occupies approximately one-third of the cell. 7. Poikilocytosis: Some degree of poikilocytosis (variation in RBC shape) can be seen on normal adult blood smears. This poikilocytosis usually occurs from a mix of cells types. 8). Based on the percentage of high- or lowfrequency cells in the blood, the degree of poikilocytosis can be graded. 9). 10 highlights distinct red cell abnormalities and their associated disorders. Central pallor >1/2 but <2/3 of RBC.
These “H” bodies are often mistaken for reticulocytes. Upon closer examination, you can see that the Hgb H inclusions give the red cell a “golf ball” appearance, with no reticulum present. B: The definitive test for Hgb H is Brilliant Cresyl Blue stain, which will demonstrate the precipitated Hgb H bodies. It is found mostly in Southeast Asia. 7 Hydrops fetalis. Defects in all four alpha chains result in hemoglobin Barts and hydrops fetalis as shown in this case. Numerous nucleated RBCs are seen and a hypochromic microcytic anemia.
1 Mechanism of microangiopathic hemolysis. Depending on where the RBC folds over the fibrin strand, different sizes of fragmented red cells will be present in the circulation. As shown in this example, these could be the small schistocyte or the larger helmet cell. This point of contact may represent a fibrin strand, microthrombi, a narrow vessel or torturous vessel, or some other physical object that sheers the RBC. Heat-associated and Other Traumatic Anemias Exposure to extremely high temperatures can damage the RBC membrane leading to significant variability in red cell size and shape (Fig.