Lab-8- hematology Assit.Lec.

Dhuha Farhan

Peripheral blood smear, Normal Picture and RBC Morphology

Sample

 To assess RBC morphology make fresh smears and smears from the blood
in EDTA.

Indications

1. This is done to see the morphology of RBC as variation and abnormality in size,
shape, structure, Hb contents and, staining characteristics.
2. Can diagnose the type of Anemia.
3. Can diagnose Thalassemia.

Pathophysiology

1. There are various sizes and shapes of RBC seen in the peripheral blood smear like:
1. Normocytic when the size is normal (7 to 8 µm).
2. Normochromic when the color is normal.
3. Microcytic when the size is smaller than normal RBC and these are less
than 6 µm.
4. Macrocytic when the size is larger than > 8 µm.
5. Spherocytes when RBCs are round without the central pale area.

9. Elliptocytes are oval or elongated RBC.

Lab-8- hematology Assit.Lec. Dhuha Farhan

10. Sickle cell is a crescent-shaped RBC seen in sickle cell anemia.

11. The target cell is RBC with a dark central area and clear space between this
dark area and periphery.

12- Acanthocytes are RBCs with small cells with thorny projections.
- found in liver disease, renal failure, and abetalipoproteinemia.

13- Teardrop cell is RBCs with a tear like an appearance.

Lab-8- hematology Assit.Lec. Dhuha Farhan

2. In the peripheral smears also note for Inclusion:

1. Howell-Jolly bodies. These are spherical purple bodies within RBCs, these
are nuclear debris.
2. Heinz inclusion bodies. These are small round inclusion of denatured
hemoglobin, seen with supravital stain or under phase microscopy.
3. Siderocytes are the RBCs containing siderotic granules which stain blue with
Prussian blue stain.
4. Basophilic stippling is the presence of punctate stippling seen with Wright
stain.