| Multiple dark blue particles of varying size scattered throughout the cytoplasm of erythrocytes is/are called: | View Page |
| The erythrocyte inclusions which are thin, red-purple staining strands of varying shapes are called: | View Page |
| A few dark blue staining granular inclusions located near the periphery of an erythrocyte are most likely: | View Page |
| Pappenheimer bodies are usually seen in patients who have had: | View Page |
| Degenerated erythrocyte cytoplasmic organelles which contain iron are: | View Page |
| Remnants of erythrocytes nuclei, nuclear fragments, or aggregates of chromosomes which have separated from the mitotic spindle are: | View Page |
| This smear shows Pappenheimer bodies. | View Page |
| Match the names of the inclusions with their corresponding diagrams. | View Page |
| This smear shows: | View Page |
| What are Pappenheimer bodies? Pappenheimer bodies are seen in the cytoplasm of mature and immature erythrocytes on a Wright's stained smear. They are composed of degenerating cellular remnants, which contain iron. Pappenheimer bodies are most likely caused by accelerated red cell division, or impaired hemoglobin synthesis. Pappenheimer bodies appear as small dark purple granular bodies of varying size frequently clustered in groups of two, three or more near the edge of the cell. | View Page |
| More on Pappenheimer bodies Pappenheimer bodies, while visible on a Wright's stained smear, should be Perls' Prussian blue stain, which is specific for iron. Pappenheimer bodies are seen in certain types of anemia characterized by an increase in the storage of iron, such as sideroblastic anemia and thallassemia. These inclusions are also seen in the peripheral blood following a splenectomy. In a healthy person with a normal spleen, Pappenheimer bodies are destroyed before the erythrocytes enter the peripheral circulation. | View Page |
| In a Wright's-stained smear, Pappenheimer bodies must be differentiated from basophilic stippling and Howell-Jolly bodies. Pick the statement which best describes each of the following. | View Page |
| What is the reason for using Perl's Prussian blue stain? | View Page |
| Howell-Jolly body and Pappenheimer bodies The red cell indicated by the arrow in the center of this field has a single Howell-Jolly body toward the lower left, as well as and several clusters of Pappenheimer bodies. | View Page |
| Cells Containing Pappenheimer Bodies The arrows in the image to the right are pointing to cells that contain Pappenheimer Bodies. | View Page |
| Basophilic Stippling contrasted with Pappenheimer Bodies This slide contrasts basophilic stippling on the left, with Pappenheimer bodies, on the right. | View Page |
| Howell-Jolly bodies and Pappenheimer bodies This image shows Howell-Jolly bodies, indicated with single arrows, and a cluster of Pappenheimer bodies, indicated with a double arrow. | View Page |
| Siderocytes This slide is stained with Perls' Prussian blue. Three siderocytes containing blue granules are indicated by arrows. These inclusions may or may not have been visible on Wright's stain, as Pappenheimer bodies. | View Page |
| This smear shows: | View Page |
| This Prussian blue stained smear shows: | View Page |
| Siderotic Granules To verify that red cell inclusions contain iron, it is necessary to use an iron stain, such as Perl's Prussian blue. The iron-containing granules are called siderotic granules. A mature erythrocyte containing siderotic granules is referred to as a siderocyte, while an immature (nucleated) erythrocyte containing siderotic granules is known as a sideroblast. A Pappenheimer body is a siderotic granule which is visible on Wright stain. All Pappenheimer bodies are Prussian blue positive, but not all siderotic granules are visible on Wright's stain as Pappenheimer bodies.
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| Which of the following statements best describes Pappenheimer bodies? | View Page |
| Three Way Comparison This slide compares basophilic stippling with Howell-Jolly bodies and Pappenheimer bodies. The slide of the left shows Pappenheimer bodies (two left arrows), and a Howell Jolly body (right arrow). The slide on the right shows basophilic stippling (left arrow), and a Howell-Jolly body (right arrow). | View Page |
| Howell-Jolly Bodies contrasted with Pappenheimer Bodies. Pappenheimer bodies are indicated with single arrows. A Howell Jolly body is shown at the double arrow. | View Page |
| This smear shows Pappenheimer bodies. | View Page |
| In which of the following conditions are Pappenheimer bodies and siderocytes seen on the peripheral smear? | View Page |
| Match the form of red cell inclusions in each of the frames of photographs with a corresponding clinical condition. | View Page |
| The red cell inclusions in this split frame photomicrograph of peripheral smears are called: | View Page |
| What are the erythrocyte inclusions that are indicated by the arrows on this blood smear? | View Page |
| Pappenheimer bodies Pappenheimer bodies are iron-containing granules that aggregate with mitochondria and are deposited in RBC or normoblast cytoplasm. Small and irregular, they are found only in pathological states as thalassemia and sideroblastic anemias(upper image). Wright-Giemsa stain defines the cytoplasmic content (protein), but Prussian blue staining is necessary to define the iron content, the essence of the Pappenheimer body (lower image). Pappenheimer bodies lie typically in small clusters (upper image) and tend to locate at the periphery of the red cell cytoplasm. A cluster is typically smaller than a single Howell-Jolly body. | View Page |
| Reticulocyte identification Reticulocytes are red blood cells prematurely released from the bone marrow. On a Wright-Giemsa stained blood smear, they appear as polychromatic macrocytes. Their presence in the peripheral blood may suggest hemolysis or bleeding. Their presence is expressed as a percentage of the red cell count: newly born= 3-7%; up to one week of age=1-3%; >one week =0.3-1.8%. Automated or manual methods may be used to enumerate reticulocytes. In clinical context, retics must be separated from debris, precipated stain, Pappenheimer bodies, Howell-Jolly bodies, and Heinz bodies. | View Page |
| The RBC inclusions shown in the photograph represent which of the following? | View Page |
| The peripheral blood smear represented by this field was submitted for hematologic review. The RBC inclusions most likely are: | View Page |