IDENTIFICATION OF

NORMAL AND
ABNORMAL FORMS OF
RED BLOOD CELLS

Prepared by: Miss. Nada Alzahrani

 Erythrocytes (RBCs)
 The normal RBCs are biconcave discs,
anucleate, essentially no organelles
 Filled with hemoglobin (Hb), a protein that
functions in O2 and Co2 transport
 Contain the plasma membrane protein
spectrin and other proteins that:
 Give erythrocytes their flexibility
 Allow them to change shape as necessary
Erythrocytes (RBCs)
 The Morphological
classification
The morphological classification of RBC is
based on:
 red cell size.
 red cell shape.
 haemoglobin content of RBC.
 red cell with inclusions.
 1. Red Cell Size:
 Red Cell Size:
1. microcytes: MCV < 80 fL
2. normocytes: MCV = (80 – 98) fL
3. macrocytes: MCV > 98 fL
4. anisocytosis: variation in red
cell size.
 Haemoglobin Content of
RBC
 Haemoglobin Content of RBC :
1. Hypochromic cell: reduced staining
of
erythrocytes.
2. Normochromic cell: normally
staining (of a
red cell).
3. Polychromatic cell: an erythrocyte
with a blue
tinge to the cytoplasm, indicating that
 The Morphological
classification
Red cell size and haemoglobin content are
classified into 3 types:
 I. Microcytic, hypochromic
 II. Normocytic, normochromic
 III. Macrocytic, polychromatic
 Microcytic Hypochromic

Causes:
Iron deficiency
anemia
Thalassemia minor
Anemia of chronic
disease
Congenital
sideroblastic
anemia
ß-Thalassemia
intermedia and
major
Hemoglobin H or E
disease
Microcytic Hypochromic
 Normocytic
Normochromic
Causes :
Anemia of
chronic disease
Early iron
deficiency
Renal failure
Aplastic anemia
Leukemia
Lymphoma
Cancer
 Macrocytic
Polychromatic
The RBC are almost as
large as the
lymphocyte.
Causes:
Megaloblastic anemia.
Alcoholism
Liver disease
Reticulocytosis
Chemotherapy
Multiple myeloma
Hypothyroidism
Macrocytic Hypochromic
 Red Cell Shape

1.Acanthocytes
Cells with irregular,
thorny
speculated
membrane
surface projections
bulbous
round ends.
 Red Cell Shape

2. Ecchinocytes:
Cells with 10-30
uniformly
distributed
spicules.
 Red Cell Shape

3. Elliptocytes:

Red blood cells

that are oval or
cigar shaped.
 Red Cell Shape

4.Spherocytes,:
Spherocytes are
almost spherical
in shape. They are
not biconcave like
a normal red
blood cell and do
not have the
central area of
pallor which a
normal red cell
 Red Cell Shape

5. Target
cells:
are abnormally
thin
erythrocytes
that when
stained show a
dark central
color spot in the
area of pallor
and a peripheral
ring of
hemoglobin,
separated by a
 Red Cell Shape

6. Tear Drop
cells:
An abnormal
erythrocyte
shaped like a
teardrop.
 Red Cell Shape

7. Stomatocytes
cells are cup
shaped with
an abnormal
area of
central pallor
that may be
oval,
elongated, or
slit like
 Red Cell Shape

8. Sickle Cells
Cells have a
sickle with
appoint at
one end.
 Red Cell Shape

9. Schistocytes
:
are red blood
cell
fragments
that result
from
membrane
damage
encountered
during
passage
 Red Cell Shape

10. Rouleaux
formation:

Occurs when
RBCs form
stacks or
rolls.
 
 Red Cell Shape

11.
Poikilocyte :
an
abnormally
shaped
erythrocyte.
(increased
variability
in the shape
of
erythrocyte
 Red Cell with Inclusions
 Red Cell with Inclusions:
1. Basophilic stippling.
2. Heinz bodies
3. Howell jolly body
4. Nucleated RBC
5. Malaria parasites
6. Reticulocyte.
Red Cell with Inclusions

1. Basophilic
stippling:
The presence
of evenly
dispersed
purplish blue
dots in the
cytoplasm of
erythrocytes.
Red Cell with Inclusions

2. Heinz
bodies :
are
denatured
particles of
haemoglobin
attached to
RBC
membrane
that appear
when stained
with cresyl
 Red Cell with Inclusions

3. Howell
jolly body :
are nuclear
fragment
found in red
cells, mostly
single but
sometimes
multiple.
Red Cell with Inclusions

4. Nucleated
RBC:

The
erythroblasts
in the
circulating
blood
(immature
red cells).
Red Cell with Inclusions

5. Malaria
parasites:
3. P.
falciparu
m
4. P. vivax
5. P. ovale
6. P. malaria
Red Cell with Inclusions

6.
Reticulocyte
:
a young
erythrocyte,
newly
released
form the
bone
marrow,
identified by
its uptake of
certain vital
Blood Smear Interpretation:

A) Normal A B C D
B) Micro/hypo
C) Macro
D) Target
E) Sphero
F) Heinz body E G H
G) Schistocyte
H) nRBC F
I) Polychrom
J) Teardrop

I J
Thank
you