1. Abnormal Blood Cell Morphology

2. Abnormal White Blood Cells
Neutrophils (AKA: PMNs, Polys, Segs)
Abnormalities in the neutrophil include…..
Greater than 5% bands
Hypersegmented nuclei (greater than 5 lobes)
Toxic granulation
Toxic vacuolization
Dohle bodies
Younger stages than the band
When do you see them in high numbers?
Bacterial infections
Inflammation
Norma l
Toxic granulation, vacuolization, & Dohle bodies are seen during bacterial infections, burns, cancer, and toxic or inflammatory states.
Hyper-segmented
Dohle bodies
Band
Toxic
granulation

3. Abnormal White Blood Cells
Eosinophils (AKA: Eos)
Greater than 3% eosinophils is abnormal
When do you see them in high numbers?
parasitic infections
allergic reactions
Basophils
Greater than 1% is abnormal
inflammatory reactions
Normal
Normal

4. Abnormal White Blood Cells
Monocyte
Greater than 10 % of WBCs in the
blood is abnormal
When do you see them in high numbers?
bacterial infections
viral infections
Lymphocyte
Greater than 40% in the blood is abnormal
Some produce and secrete antibodies
Atypical forms are larger cells with round or
irregular nucleus and abundant cytoplasm
High and atypical form during infectious mononucleosis
Normal
Normal

5. Abnormal Platelets Platelets (AKA: Thrombocytes or PLTs)
Formed from the fragments of a megakaryocyte
Megakaryocytes are found in the bone marrow
Megakaryocytes found in the peripheral blood
are abnormal
Many giant platelets are abnormal
Abnormal platelets are
Larger than 3 micrometers in diameter
Giant thrombocytes or giant platelets are seen occasionally
Normal is between 7-20 per field
Decreased is <7 per field
Increased is >20 per field

6. Abnormal Red Blood Cells
Red Blood Cells (AKA: Erythrocytes of RBCs)
Can be normal sized (oval or round) 6-8 micrometers in diameter= called normocytic
Can be smaller than normal <6 micrometers = called microcytic
Can be larger than normal >8 micrometers= called macrocytic
Anisocytosis is when they RBCs vary drastically in size
Poikilocytosis is when the RBCs vary drastically in shape
If the RBC color is normal = called normochromic
If the RBC color is decreased = called hypochromic
(larger central pallor)

7. Abnormal Red Blood Cells
Red Blood Cells (AKA: Erythrocytes of RBCs)
Can be compact RBCs, dark, dense, small = called spherocytes
Can be crescent shape and pointed = called sickle cells (depranocytes)
Can appear mouth-like = called stomatocytes
Can appear like ovals or elongated = called ovalocytes or elliptocytes
Can appear target shaped or bull’s eye = called target cells (Codocytes)

8. Abnormal Red Blood Cells
Red Blood Cells (AKA: Erythrocytes of RBCs)
Can be spiny = called acanthocytes
Fragmented cells is a broad category and includes many different types of cells.
Schistocytes (Keratocytes) and Helmet cells are examples of fragmented cells.
Nucleated RBCS  usually found only in the bone marrow.
Can be seen in the peripheral blood in severe anemia and in newborns.

9. Abnormal Red Blood Cells
Common Red Blood Cell Inclusions
Howell-Jolly bodies
From left over DNA found in the RBC.
Appear as round, deep purple circles
around 2 micrometers in diameter.
Found in patients after their spleen has
been removed or when RBC production is rushed,
pernicious anemia and hemolytic anemia.
Pappenheimer bodies
Small, light purple, beads, made from iron.
Located near the periphery of the RBC.
Need to be stained with Prussian blue to
determine in they are true Pappenheimer bodies.
Seen in iron loading anemias and hereditary
hemochromatosis.

10. Abnormal Red Blood Cells
Common Red Blood Cell Inclusions
Basophillic stippling
Remains of RNA and mitochondia.
Diffuse granules found throughout the cytoplasm.
Found in patients that have fast RBC growth.
Found in patients with lead poisoning.
Heinz bodies
Denatured hemoglobin
Large 1-3 micrometers in diameter.
Located near the periphery of the RBC.
Special staining with a supravital stain is needed to
visualize Heinz bodies.
Found in patients with G6PD deficiency and with
some hemoglobinopathies.