Normal red cell
Fragile,
biconcave,disk like structures.
Have smooth round surface.
Diameter ranges from 7.5 – 7.8µm.
Have no nucleus.
Whole cell is filled with hemoglobin.
Anisocytosis
variation in size of RBC.
Types:
Macrocytosis – the average size of
rbc is more than normal.
Microcytosis – the average sie of RBC
is less than normal.
Poikilocytosis
Variation in shape of rbc .
Spherocytes
Ovalocytes
Burr cells
Crenated red cells
Schistocytes
tear drop cells
Acanthocytes
Target cells
Sickle cells
Pencil cells
Inadequate hemoglobin formation
Hypochromasia- RBC’s have decrease hemoglobin
concentration.
Eg: Iron deficency anemia, chronic infection .
Hyerchromasia- RBC’s have increased hemoglobin
concentration.
Eg: Meglobalstic anemia , spherocytosis.
COMPENSATORY ERYTHROPOIESIS
A number of changes are assosiated with
compensatory increase in erythropoietic increase in er
POLYCHROMASIA
ERYTHROBLASTEMIA
PUNCTATE BASOPHILIA
HOWELL JOLLY BODIES
Polychromasia
Red cells having more than one type of colour .
Erythroblastemia
Presence of nucleated RBC’S
Howell jolly bodies
Purple nuclear remanent usually found single and
large than punctate basophil
Punctate Basophilia
also called as basophilic stippiling it is diffuse and
uniform basophilic granularity in cell.
Examination of bone marrow aspiration
smear
Cellularity.
Differential count.
Myeloid:Erythroid ratio.
Erythroid series : Maturation sequence , type of
maturation .
Myeloid series: Maturation sequence , cytologic
abnormalaities.
Megloblastic series: Normal , abnormal forms .
Lymphocyte series.
Plasma cell series.
Morphological classification of anemia
1. Microcytic hypochromic anemia
2. Macrocytic anemia
3. Normocytic and normo chromic anemia
Microcytic hypochromic anemia
Iron deficency anemia
thalessemia
anemia of chronic disease
sideroblastic anemia
Macrocytic anemia
Megloblastic Non megloblastic
Folate or vitamin b12 alcoholoism
deficency liver disease
hemolytic anemia
myelodysplastic
syndrome
hypothyrodism
Normocytic and normochromic anemia
Reticulocyte count Reticulocyte count
increased decreased
recent blood loss aplastic anemia
hemolysis chronic renal failure
anemia of chronic disease
anemia due to infiltration of
marrow
Morphology of iron deficiency anemia
Peripheral blood smear Bone marrow examination
Red cells are small (microcytic) marrow cellularity increased
they are pale (hypochromic) due to erythroid hyperplasia
Normal red cells with sufficient decrease in
hemoglobin have zone of center myeloid :erythroid ratio
pallor . normablastic
Poikilocytosis is small and
erythrocypoesis with
elongated red cells ( pencil
predominant small
cells)
polychromatic normoblast .
Target cell, elliptical forms and
polychroamtic cells are often
present.
Megloblastic anemia
Peripheral blood smear Bone marrow examination
Macrocytosis the marrow is hyper cellular
demonsetrate marked decrease in myeloid:erythroid
anisocytosis and poikilocytosis ratio
Erythroid hyperplasia is due to
prescence of macroovalocyte
megloblastic erythropoisis
basophilic stippling and megloblast are abnormal, large ,
occasional normoblast may be nucleated erythroid precursors,
seen nuclei are less mature than the
Hypersegmented development of cytoplasm.
Megloblast with abnormal mitosis
neutrophils(more than 5
nuclear lobes ) may be seen .
Giant form of metamyelocytes and
Myelocyte is occasionally seen
band forms may be present
Morphology of aplastic anemia
Blood smear Bone marrow examination
normocytic normochromic It may yeild dry tap
reticulocyte count is reduced a trephine biopsy is used
or zero patchy cellular areas in a
absolute granulocyte count is hypocellular or aplastic
particularly lowwith relative marrow due replacement of
lymphocytosis. fat.
platlets are always reduced Severe depression of myeloid
cells , megakaryocyte and
erytroid cells
marrow cheifly consists of
lymphocytes and plasma cells
