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Normal Blood Cells morphology

Normal Blood Cells morphology
Normal neutrophil in the center of the field. The red cells show normal hemoglobinization.

Iron deficiency anaemia

Significant hypochromia and microcytosis is seen, as well as moderate variation in size and shape of the red cells.

Iron deficiency anemia

Redness and atrophy of tongue papillae, smooth dorsal surface of the tongue. Angular chelosis

Here is a hypersegmented neutrophil that is present with megaloblastic anemias. There are 8 lobes instead of the usual 3 or 4. Such anemias can be due to folate or to B12 deficiency. The size of the RBC's is also increased (macrocytosis, which is hard to appreciate in a blood smear).
Megaloblastic anemia

Megaloblastic anemia

Bilateral angular chelosis in megaloblastic anemia
Bruises in megaloblastic anemia


Macrocytic Anaemia
A huge hypersegmented neutrophil is seen in this high oil view of the peripheral blood The patient's diagnosis was pernicious anemia

Thalassaemia

B-thalassaemia major
Hypochromic microcytes, target cells, a nucleated red blood cell (normoblast ).

B-Thalassaemia Major

Sickle Cell Anaemia
A sickled cell is seen, as is a classic target cell in the center of the field. There is some anisocytosis and poikilocytosis, as well as some faint basophilic stippling in one cell.

Normal values Hb A1 = > 95 % (95 to 98 %). Hb A2 = 1.5 to 3.7 % Hb F = < 2 % (0.8 to 2 %). Hb S = 0 %. Hb C = 0 %. Newborn Hb F = 50 to 80 %. <6 months = <8 %. >6 months = 1 to 2 %.

Hereditary Spherocytosis

A normal lymphocyte and many spherocytic red cells are seen



Hereditary Spherocytosis The size of many of these RBC's is quite small, with lack of the central zone of pallor. These RBC's are spherocytes. In hereditary spherocytosis, there is a lack of spectrin, a key RBC cytoskeletal membrane protein. This produces membrane instability that forces the cell to the smallest volume--a sphere. In the laboratory, this is shown by increased osmotic fragility. The spherocytes do not survive as long as normal RBC's.





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