Term
Meaning
Possible Significance
anisocytosis
variation in cell size
corresponds to raised RDW (see Full Blood Count)
poikilocytosis
variation in cell shape
may be diagnostic (e.g. spherocytes)
macrocytosis
raised red cell volume
B12/folate deficiency, ethanol, hypothyroidism
microcytosis
reduced red cell volume
iron deficiency, thalassaemia trait
rouleaux
'chains' of red cells
raised protein in plasma e.g. myeloma, inflammation
agglutination
'clumped' red cells
col autoagglutination
spherocytes
small round red cells
hereditary, autoimmune
elliptocytes
rod shaped red cells
hereditary, elliptocytosis
target cells
dark centre to red cells
thalassaemia, liver disease, iron deficiency, Hb C (Afro-Caribbeans)
polychromasia
large basophilic red cells
immature red cells (bleeding, haemolysis)
Howell Jolly bodies
nuclear remnants in red cells
post-splenectomy, hyposplenism
Heinz bodies
denatured haemoglobin
oxidative haemolysis (e.g. G6PD deficiency)
Burr cells
irregularly crenated red cells
renal failure, hypothyroidism
acanthocytes
spiky red cells
liver disease
shistocytes
red cell fragments
mechanical e.g. prosthetic heart valves, DIC
left shift
myelocytes and meta-myelocytes in film
infection, marrow infiltration
right shift
hypersegmented polymorphs
megaloblastic anaemia
toxic granulation
increased granulation in neutrophils
implies bacterial infection
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Blood film interpretation
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