1. Normal blood film
a zone of
central pallor about one third the size of the RBC
diameter
Platelet (small and
Blue-staining)
An RBC is about two
thirds the size of a normal lymphocyte
Normal mature
lymphocyte
minimal variation in
size (anisocytosis) and shape (poikilocytosis)

2. This case is an autoimmune hemolytic anemia
Spherocytes that lack central pallor
Reticulocyte…large and blue

3. Hereditary spherocytosis

4. Heinz body inclusions in
glucose-6-phosphate dehydrogenase (G6PD)
deficiency
methylene blue stain

5. Sickle cell anemia

6. Megaloblastic anemia
macro-ovalocytes
The
increased size of the RBCs (macrocytosis) is hard
to appreciate in a blood smear. Compare the
RBCs with the lymphocyte at the lower left
center
The mean corpuscular volume can be mildly
increased in individuals recovering from blood
loss or hemolytic anemia because the newly
released RBCs, the reticulocytes, are increased in
size over normal RBCs, which decrease in size
slightly with aging
This is a case of pernicious
anemia

7. Hypochromic anemia, microscopic
There is also increased anisocytosis
(variation in size) and poikilocytosis (variation in
shape)

8. This peripheral blood smear shows a nucleated
RBC in the center that contains basophilic
stippling of the cytoplasm. This suggests a toxic
injury to the bone marrow, such as lead
poisoning. Such stippling may also appear with
severe anemia, such as a megaloblastic anemia.

9. Microangiopathic hemolytic anemia

10. myelofibrosis

11. AML…acute promyelocytic leukemia
Auer rods

18. AML

23. Thank you