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Clinical Pathology
Erythron
| Question | Answer |
|---|---|
| Rouleaux | loose, linear association of RBCs with one another due to alterations in membrane surface charges |
| Autoagglutination | irregular clumping, does not disperse in saline |
| Macrocytes | Cells larger than normal |
| DDX for Macrocytes | Hereditary macrocytosis of poodles, FeLV infections, Preleukemic conditions in cats/dogs, Vit B12 deficiency of giant schnazers, possible regeneration in an anemic horse |
| Microcytes | cell smaller than normal |
| DDX for micocytes | Iron deficiency, Heinz bodies, potential epicellularhemoparasites, normal in some breeds |
| Polychromasia | Young erythrocytes that stain purple/blue-gray, New Methylene Blue staining = reticulocytes |
| Hypochromia | increased central pallor/ decreased cytoplasmic staining |
| DDX for Hypchromia | Iron deficiency, Lead toxicosis |
| Poikilocytosis | Any shape change in erythrocytes, common in pigs, calves, goats. Certain shapes are associated with certain diseases. |
| Echinocytes | RBCs that have uniform membrane projections,- commonly in vitro artifact. |
| DDX for Echinocytes | Artifact, Uremia, electrolyte depletion, lymphoma, doxurobicin toxicity, glomerulonephritis |
| Keratocytes | Two projections of the cell membrane, from rupture of a vesicle. Associated with oxidative damage to the cell membrane, also with Heinz bodies. |
| Schistocytes | Irregular fragments of RBCs that vary in size and shapes. Associated w/ trauma to RBCs from shearing by fribrin strands within vasculature |
| DDX for Schistocytes | Disseminated intravascular coagulation (DIC), Hemangiosarcoma, Glomerulonephritis, Congestive heart failure, Myelofibrosis, Chronic Doxorubicin toxicosis, Generalized vasculitis |
| Acanthocytes | Erythrocytes with several irregularly-spaced membrane projections, often irregularly shaped overall. Seen with RBC trauma. Believed to be caused by altered ration of lipid-cholesterol within erythrocyte |
| DDX for Acanthocytes | Hemangiosarcoma, Glomerulonephritis, Lymphoma, Hepatopathies |
| Fusocytes | spindle-shaped erythroctyes. Normal in Angora goats. |
| Elliptocytes (ovalocytes) | Thin, oval RBCs- normal in camelids. Occasionally in other species with Iron deficiencys. Rare hereditary condition in dogs. |
| Dacrocytes | Teardrop-shaped cells, cells that were unable to return to normal shape after passing through vessel. Maybe fixing artifact. Llamas w/ iron deficiency. |
| Drepanocytes | Sickle-shaped. Normal in cervids (deer). Artifact that occurs when RBCs are exposed to air. |
| Leptocytes | Thin cells with more membrane relative to cell volume "wrinkled" |
| Stomatocytes | Type of leptocyte that is bowl-shaped. Has oval/linear area on central pallor on blood smear. Hereditary in some breeds. May be an artifact. |
| Codocytes | Type of leptocyte that are bell-shaped and target-shaped on blood smear. Associated with hepatopathies, iron deficiency anemia, and reticulocytosis/polychromasia. |
| Spherocytes | Removal of portions of damaged cell membrane by splenic macrophages. Cells round up and becomes spherical. No central pallor can be appreciated- cells are small dark all the way across. Only identify in dog. |
| Basophilic stippling | very small, blue-purple dots evenly distributed evenly through an entire erythrocyte. Dots are aggregates of residual RNA & protein. |
| DDX for Basophilic stippling | lead toxicosis, regenerative anemias (sheep, cattle, sometimes cats) |
| Siderotic Inclusions | Basophilic inclusions that are focally distributed inside an RBC (siderocyte). Inclusion bodies contain iron. |
| DDX for Siderotic Inclusions | Hemolytic anemias, Lead toxicity, Dyserythropoiesis, Myeloproliferative diseases, Chloramphenicol treatment, Idopathic cases |
| Howell-Jolly Bodies | Round, deeply basophilic (dark purple) structures within the cytoplasm of RBC, typically single, sometimes 2 present. Seen in low numbers or part of regenerative response. Removed by spleen. |
| Heinz Bodies | Small, red/pink, round protuberance("nose") on the side of erythrocytes. Caused by oxidative damage, made of aggregates of denatured, precipitated hemoglobin. New Methylene Blue staining = good. |
| Eccentrocytes | Clear, crescent-shaped area remains at one side of erythrocyte. Due to oxidative change in which hemoglobin moves to one side of RBC |
| Nucleated erythrocytes (nRBCs) | Immature erythrocytes that have been prematurely released. Seen due to regenerative response in anemic dogs/cats. Can be seen in hypoxic animals. |
| DDX of nRBCs of non-anemic patients | Lead toxicity, Iron/Copper deficiency, splenic disease (hemangiosarcoma), Bone marrow (myelophthisis, trauma/necrosis, Endotoxemia, drug toxicity, Myelodysplasia secondary to infectious disease, herditary macrocytosis of poodles) |
| Viral Inclusions | Irregular, round, or ring-shaped, found within the cytoplasm of RBCs and leukocytes. Associated w/ distemper in dogs. |
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bbvet
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