|What are the abnormal red blood cells that are indicated by the arrows in this peripheral blood smear image?||View Page|
|What are the cells that are indicated by the arrows in this peripheral blood smear image?||View Page|
|What is the cell that is indicated by the arrow in this field?||View Page|
|Match the forms of poikilocytosis on the left with the physiological/environmental condition associated with their formation on the right:||View Page|
|Match the following terms with synonyms:||View Page|
|The identification of which of the following abnormal forms may contribute significantly to specific clinical diagnosis:||View Page|
|What type of red cells are indicated by the arrows in this image?||View Page|
|The cell seen in the center of this field is:||View Page|
|The abnormal form seen in the center of this slide is:||View Page|
Another example of an echinocyte is seen in the center of this slide. In rare instances, echinocytes circulate in vivo in uremia, following heparin injection, in certain congenital anemias and in pyruvate kinase deficiency. Plastic slides must be used to verify the presence of in vivo echinocytes. Since echinocytes do not aid in the diagnosis of these conditions, their main importance lies in the fact that they are artifactual and reversible and must be distinguished from acanthocytes.
|Which of the following forms are frequently artifactual?||View Page|
|What are the abnormal red cells indicated by the arrows in this field?||View Page|
|What are the cells that are indicated by the arrows in this field?||View Page|
|Burr Cells (Echinocytes)|
Echinocyte comes from the Greek word meaning "sea urchin," which relates to its shell-like appearance. Echinocytes, more commonly referred to as burr cells, are reversible, meaning that this alteration can be the result of the cell's environment, pH of the medium (including the glass slides on which blood smears are made), the metabolic state of the cell and the use of some chemical substances. Several echinocytes (burr cells) can be seen in the top image; three of them are indicated by the arrows. Notice that the projections are rounded and evenly spaced around the cell and the cells have central pallor. Acanthocytes, by contrast, have irregularly spaced thorn-like projections and little or no central pallor. Although burr cells may be associated with diseases, such as uremia or pyruvate kinase deficiency, crenated cells, that may be confused with true burr cells/echinocytes, are frequent artifacts. Crenated erythrocytes are most commonly caused by excess EDTA (underfilled collection tube), but may also be caused by slow drying, drying in a humid environment, or an alkaline pH from glass slides. When crenation is an artifact, most cells on the slide will exhibit this characteristic. True burr cells are less numerous. Corrective actions include making a new smear or re-collecting the sample, if possible. The bottom image contains crenated cells that were the result of an underfilled EDTA collection tube. These should not be reported.
|The predominant abnormal forms seen in this field are:||View Page|
|Synonym for echinocytes|
The synonyms for echinocytes are burr cells and crenated cells.
The term, stomatocyte, is derived from the Greek term, stoma, meaning mouth. Stomatocytes have elongated or slit-like central pallors, which may be curved, giving the central pallor an appearance of a smiling mouth. The occasional stomatocyte seen in normal smears is the result of a slight pH change in the environment, similar to the in vitro changes that cause cells to assume the echinocyte shape. Two stomatocytes are indicated by arrows on this slide.
|What are the abnormal red blood cells that are indicated by the arrows in this image?||View Page|
|What is the predominant abnormal forms seen in this slide?||View Page|