Red Cell Morphology

		Hypochromasia Morphology: Increase in the red cells' central pallor which occupies more than the normal third of the red cell diameter. Found in: Iron deficiency Thalassaemia And any of the conditions leading to microcytosis
		Polychromasia Morphology: Red cells stain shades of blue-gray as a consequence of uptake of both eosin (by haemoglobin) and basic dyes (by residual ribosomal RNA). Often slightly larger than normal red cells and round in shape - round macrocytosis. Found in: Any situation with reticulocytosis - for example bleeding, haemolysis or response to haematinic factor replacement.
l		Anisocytosis Morphology: An increase in the variability of red cell size.Variation in erythrocyte size is now measured by the red cell distribution width (RDW). Always take the RDW into acount when interpreting the mean corpuscular volume (MCV).
		Microcytosis Morphology: Decrease in the red cell size. Red cells are smaller than ± 7µm in diameter. The nucleus of a small lymphocyte (± 8,µm) is a useful guide to the size of a red cell. Found in: Iron deficiency anaemia Thalassaemia Sideroblastic anaemia Lead poisoning Anaemia of chronic disease
		Macrocytosis Morphology:Increase in the size of a red cell. Red cells are larger than 9µm in diameter. May be round or oval in shape, the diagnostic significance being different. Found in:Folate and B12 deficiencies (oval) Ethanol (round) Liver disease (round) Reticulocytosis (round)
		Dimorphic Blood Picture Morphology: Two distinct populations of red cells.The populations may differ in size, shape or haemoglobin content. Found in: Anaemic patient after transfusion Iron deficiency patient's taking supplements Combined B12 / folate and iron deficiency Sideroblastic anaemia
		Spherocytosis Morphology: Red cells are more spherical. Lack the central area of pallor on a stained blood film. Found in: Hereditary spherocytosis Immune haemolytic anaemia Zieve's syndrome Microangiopathic haemolytic anaemia.
		Stomatocytosis Morphology: Red cells with a central linear slit or stoma. Seen as mouth-shaped form in peripheral smear. Found in:Alcohol excess Alcoholic liver disease Hereditary stomatocytosis Hereditary spherocytosis
		Acanthocytosis Morphology: Spherical cells with 2 - 20 spicules of unequal length and distributed unevenly over the red cell surface. Found in:Liver disease Post splenectomy Anorexia nervosa and starvation
		Target Cells Morphology: Red cells have an area of increased staining which appears in the area of central pallor. Found in:Obstructive liver disease Severe iron deficiency Thalassaemia Haemoglobinopathies (S and C) Post splenectomy
		Elliptocytosis Morphology: The red cells are oval or elliptical in shape. Long axis is twice the short axis. Found in: Hereditary elliptocytosis Megaloblastic anaemia Iron deficiency Thalassaemia Myelofibrosis
		Cigar Cells Morphology: Red cells shaped like a cigar or pencil Found in: Iron deficiency
		Schistocytosis Morphology: Fragmentation of the red cells. Found in: DIC Micro angiopathic haemolytic anaemia Mechanical haemolytic anaemaia
		Echinocytes Morphology: Red cells are covered with 10 - 30 short spicules of regular form. Found in: Uraemia Severe burns EDTA artefact Liver disease
		Sickle Cells Morphology: Sickle shaped red cells Found in: Hb-S disease
		Tear Drop Cells Morphology: Red cells shaped like a tear drop or pear Found in:Bone marrow fibrosis Megaloblastic anaemia Iron deficiency Thalassaemia
		Rouleaux Formation Morphology: Stacks of RBC's resembling a stack of coins Found in: Hyperfibrinogenaemia Hyperglobulinaemia
		Red cell-agglutination Morphology: Irregular clumps of red cells Found in:Cold agglutinins Warm auto immune haemolysis
		Howell-Jolly Bodies Morphology:Small round cytoplasmic red cell inclusion with same staining characteristics as nucleus. Found in: Haemolytic anaemias Post splenectomy Megaloblastic anaemia
		Malaria Parasities Plasmodium falciparum Morphology:Ring form of Pl falciparum in red cells. Delicate rings with 1 or 2 chromatin dots. Often more than one ring in a red cell. Accolé forms are found. Found in:Malaria
		Basophilic stippling Morphology: Considerable numbers of small basophilic inclusions in red cells. Found in: Thalassaemia Megaloblastic anaemia Haemolytic anaemia Liver disease Heavy metal poisoning