Dimorphic RBC population from Red Cell Disorders: Peripheral Blood Clues to Nonneoplastic Conditions, presented by MediaLab

Erythrocyte Disorders: Smear Case 4: Dimorphic Red Cell Population

Dimorphic RBC population

Illustrated in the photomicrograph of a peripheral smear are two populations of erythrocytes.
Approximately 50% of the erythrocytes are normal size and contain a full complement of hemoglobin. The patient had received blood transfusions. The transfused red blood cells are the normocytic, normochromic red cells.
Admixed are microcytic erythrocytes and larger erythrocytes, some faintly mottled or smudged, suggestive of reticulocytes.
This picture represents a hemolytic process with a reticulocyte response.
A similar dimorphic red cell population appears following erythropoietin therapy.
It is important to recognize when a population of cells in the peripheral smear is not in context with anticipated laboratory findings and the clinical situation.

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