Table 6: Red Blood Cell Inclusions Review - LabCE.com, Laboratory Continuing Education

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Table 6: Red Blood Cell Inclusions Review

Inclusion	Image	Description	Associated Diseases and Conditions
Basophilic stippling		Coarse basophilic stippling reflects abnormal hemoglobin synthesis and abnormal RNA degradation. Fine diffuse stippling may be artifactual due to slow drying of the slide.	Lead poisoning Thalassemia Sideroblastic anemia Megaloblastic anemia Alcoholism Congenital dyserythropoietic anemia Myelodysplasia Post-treatment for iron deficiency anemia
Pappenheimer bodies		Hemosiderin-containing granules Inclusions may also be seen in nucleated red blood cells (nRBCs).	Sideroblastic anemia Hemolytic anemia Megaloblastic anemia Thalassemia Congenital dyserythropoietic anemia Myelodysplastic syndromes Absent or atrophic spleen Hyposplenism
Heinz bodies		Precipitated, denatured hemoglobin attached to or protruding through cellular membrane. Supravital staining is required to visually see Heinz bodies.	Hemolytic anemia due to unstable hemoglobins G6PD deficiency Exposure to oxidizing drugs Chemical poisoning
Howell-Jolly bodies		Residual nuclear DNA May see more than one inclusion per cell in megaloblastic anemia.	Megaloblastic anemia Hemolytic anemia Alcoholism Absent or atrophic spleen Hyposplenism
Siderosomes		Found in normal bone marrow Seen in sideroblasts (normoblasts containing ferritin granules). Image displays ringed sideroblasts. The iron-staining particles surrounding the nucleus of red blood cells create ringed sideroblasts. Iron has accumulated in the mitochondria of erythroblasts; the mitochondria are located close to the nucleus, giving the ringed appearance.	Dyserythropoiesis Iron overload Myelodysplastic syndromes Sideroblastic anemia
Nucleated red blood cells (nRBCs)		Immature RBCs may appear in the peripheral blood in moderate and severe anemias. Typically circulating nucleated RBCs are at the orthochromic stage of maturation, as shown in the image to the left.	Moderate to severe anemia Increased bone marrow response