Sample Question from Red Cell Disorders: Peripheral Blood Clues to Nonneoplastic Conditions, presented by MediaLab

Erythrocyte Disorders: Smear Case 3: Intracellular RBC Inclusions

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.

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