| Pappenheimer Bodies Pappenheimer bodies may be seen in the cytoplasm of mature and immature erythrocytes on a Wright-stained peripheral blood smear. They 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. They are composed of degenerating cellular remnants that contain iron. Pappenheimer bodies are most likely caused by accelerated red cell division or impaired hemoglobin synthesis. | View Page |
| Pappenheimer Bodies, continued Pappenheimer bodies, while visible on a Wright's stained smear, should be confirmed with an iron stain, such as Prussian blue stain. The image on the right is a Prussian blue stain that confirms the presence of Pappenheimer bodies. Wright stain does not stain the iron, but rather the protein matrix that contains the iron.Pappenheimer bodies are seen in certain types of anemia that are characterized by an increase in the storage of iron, such as sideroblastic anemia and thalassemia. 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 |
| Match the descriptions below with the erythrocyte inclusions from the drop down box that they describe. The descriptions refer to the appearance of the inclusions on a Wright-stained peripheral blood smear. | View Page |
| Pappenheimer Bodies, continued The arrows in the image on the right are pointing to cells on a Wright-stained smear 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. If the smear was stained with Prussian blue iron stain, the Pappenheimer bodies would stain blue, indicating the presence of iron, but the Howell-Jolly bodies would not stain blue, indicating the absence of iron. | View Page |
| Siderocyte This slide is stained with Prussian blue stain. The cell indicated by the arrow is a siderocyte. The inclusions in the cell may or may not have been visible on a Wright-stained smear. If they were visible on a Wright stained smear, they would be designated as Pappenheimer bodies. | View Page |
| Siderotic Granules To verify that red cell inclusions contain iron, it is necessary to use an iron stain, such as Prussian blue. The iron-containing granules are called siderotic granules. Pappenheimer bodies are siderotic granules that are visible on a Wright-stained smear. All Pappenheimer bodies are Prussian blue positive, but not all siderotic granules are visible on Wright-stained smears as Pappenheimer bodies. 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. | View Page |
| Comparison of Erythrocyte Inclusions In section A of the image, the arrow points to an RBC with basophilic stippling.In section B, the arrows point to erythrocytes containing Pappenheimer bodies.The arrows are pointing to Howell-Jolly bodies in section C.By contrast, in section D the arrow is pointing to a platelet that is sitting on top of an RBC. This may be mistaken for an inclusion. One of the distinguishing characteristics that can alert you to the fact that it is not an inclusion is the halo around the platelet. | View Page |
| The inclusions that are indicated by the arrows on this Wright-Giemsa stained peripheral blood smear are most likely Pappenheimer bodies. | View Page |
| Multiple small, dark blue particles scattered throughout the cytoplasm of erythrocytes is/are called: | View Page |
| The erythrocyte inclusions which are thin, red-purple staining strands usually found in figure-eight 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: | View Page |
| Degenerated erythrocyte cytoplasmic organelles that contain iron are: | View Page |
| Remnants of erythrocyte nuclei, nuclear fragments, or aggregates of chromosomes are called: | View Page |
| This smear shows Pappenheimer bodies. | View Page |
| Match the names of the inclusions with their corresponding diagrams. | View Page |
| This image represents a field of red blood cells (RBCs) that were stained using a supravital stain. How would these cells appear if they were viewed on a Wright stained smear? | 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 thalassemia. 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 on 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. The cell indicated by an arrow is a siderocyte. The inclusions (siderosomes) in the cell may or may not have been visible on Wright's stain. If they were visible on a Wright's stained smear, they would be designated as Pappenheimer bodies. | View Page |
| This smear shows: | View Page |
| Which of the following terms most accurately identifies the cell indicated by the arrow in this Prussian blue-stained bone marrow smear? | 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 |
| Comparison of Erythrocyte Inclusions In section A of the image, the arrow points to an RBC with basophilic stippling.In section B, the arrows point to erythrocytes containing Pappenheimer bodies.The arrows are pointing to Howell-Jolly bodies in section C.By contrast, in section D the arrow is pointing to a platelet that is sitting on top of an RBC. This may be mistaken for an inclusion. One of the distinguishing characteristics that can alert you to the fact that it is not an inclusion is the halo around the platelet. | 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 |
