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Stippling Information and Courses from MediaLab, Inc.

These are the MediaLab courses that cover Stippling and links to relevant pages within the course.

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CLIA Hematology / Hemostasis Review
Coarse basophilic stippling in all of the following EXCEPT:View Page
Seen in infections and inflammations the cell indicated by the arrow in this illustration is exhibiting:View Page

Erythrocyte Inclusions - Wright Stained Smears
Coarse Basophilic Stippling

Coarse basophilic stippling is present in the cell in the center of this slide. The granules are larger and more prominent than those seen in fine stippling.

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What is Basophilic Stippling?

On a Wright's-stained smear, the presence of multiple dark blue particles or granules of varying size, scattered throughout the cytoplasm of erythrocytes in the reticulocyte stage is called basophilic stippling. There are two types of stippling, fine or diffuse, and coarse or punctate. The erythrocyte containing them may stain normally in other respects or it may be polychromatophilic.

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Normal Peripheral Blood Cells
Glossary of Terms N through Z.

N:C Ratio - Nuclear: cytoplasmic Ratio - The ratio of nuclear volume to cytoplasmic volume within any one cell.Neoplasm - Any new and abnormal growth, such as a tumor.Neutrophilic Granules - Specific granules present in the cytoplasm of neutrophils. These granules resemble pencil stippling and stain a lilac color due to their affinity for both basic and acid dyes.Phagocyte - Any cell that ingests microorganisms or other cells and foreign particles.Phagocytosis - The ingestion and destruction of microorganisms or other foreign particles.Plasma - The fluid portion of blood in which the various blood cells are suspended.PF3 (platelet Factor 3) - A lipoprotein component of the platelet membrane; functions as a surface catalyst during blood coagulation.Pseudopod - A temporary protrusion of the cytoplasm of a cell.Refractile - Capable of refracting or changing the direction of light.Senescence - The process or condition of growing old.Serotonin - A constituent of blood platelets and other cells and organs; induces constriction of the blood vessels.Specific Granules - Granules found in cells of the more mature stages of the granulocytic series. They have distinct staining reactions which differ with each type of granulocyte.T-cell - Thymus derived lymphocyte which mediates cellular immunity.Thrombocyte (Platelet) - A circular or oval disk found in the blood; concerned with hemostasis.Thymus - A ductless gland-like body situated in the anterior mediastinal cavity; reaches its maximum development during the early years of childhood.Vacuole - Any small space or cavity formed in the cytotoplasm of a cell.

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Appearance of a Band Neutrophil

A band has moderate to abundant cytoplasm staining pale blue to pink. Present within the cytoplasm are fine lilac to pink granules. These specific granules, called neutrophilic granules, are small and somewhat resemble pencil stippling.

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Red Cell Disorders: Peripheral Blood Clues to Nonneoplastic Conditions
The peripheral blood smear represented by this field was submitted for hematologic review. The RBC inclusions most likely are:View Page
Hemolytic disease of the newborn

Jaundice was recognized in a day-old infant. Notice particularly the size variation (anisocytosis) of the erythrocytes on the infant's peripheral smear. What does this observation mean? Does it provide immediate information that might serve as guidance in expediting diagnosis and treatment? Note that normal-sized red blood cells, microcytes, microspherocytes, macrocytes, and nucleated red blood cells are all present. Red cell variations are expected findings in healthy neonates, but the variations here are exaggerated. Hyposplenic functional features may appear, including acanthocytes, spherocytes, and possibly Howell-Jolly bodies, especially if hemolysis is particularly vigorous. A high (3-7%) reticulocyte count is not unusual during the first three or four days after birth, however, the marrow in this jaundiced infant is proliferating vigorously in response to hemolysis. A call for more red cells is urgent. Immature red cells (in the form of nucleated red cells) and red cells with stippling of RNA (basophilic stippling) are readily identified. Red cell maturation sequence has not been totally processed in the marrow nor is all residual red cell debris removed by the spleen. In the lower photograph are reticulocytes stained by supravital stain (new methylene blue). Basophilic stippling (specks of RNA) stains with both supravital stains and with routine Wright-Giemsa stain.

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Poikylocytosis and Basophilic Stippling

Poikylocytosis that includes tear-drop shaped erythrocytes, schistocytes, and target cells is present in both the upper and lower photographs. In addition, macrocytes are present, two of which (one in each field) have coarse basophilic stippling. The stippling may represent abnormal hemoglobin synthesis. These stippled erythrocytes remain in circulation in the absence of pitting by a spleen.

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