Poikilocytosis Review Table - LabCE.com, Laboratory Continuing Education

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Poikilocytosis Review Table

Cell Type	Image	Cellular Description	Associated Diseases and Conditions
Teardrop cell		Red blood cells (RBCs) are shaped like a teardrop with a projection extending from one end.	Myelofibrosis with myeloid metaplasia (MMM)
Spherocyte		RBCs smaller than normal No central pallor Round rather than disc-shaped	Hereditary spherocytosis Certain hemolytic anemias (eg, autoimmune hemolytic anemia) Severe burns
Target cell		RBCs with characteristic bull's-eye morphology due to hemoglobin distribution	Hemoglobinopathies (e.g., sickle cell disease) Certain thalassemias Iron deficiency anemia Splenectomy Severe liver disease
Sickle cell		RBCs contain hemoglobin S. Thorn or crescent-shaped	Sickle cell anemia
Stomatocyte		RBCs with thin, elongated area of central pallor (slit-like, or coffee-bean-shaped on peripheral blood smears) Three-dimensionally, RBCs are cup-shaped.	Hereditary stomatocytosis Alcohol-related disease Liver disease Rh null phenotype Artifact
Schistocyte (fragmented red cells)		RBC blood cell fragments or pieces Vary widely in size and shape	Severe burns Hemolytic uremic syndrome (HUS) Microangiopathic hemolytic anemia (MAHA) Disseminated intravascular coagulation (DIC) Thrombotic thrombocytopenic purpura (TTP)
Ovalocyte (elliptocyte)		RBCs are elongated-oval, cigar, or pencil-shaped.	Hereditary elliptocytosis Megaloblastic anemia Myelophthisic anemia Certain thalassemias Severe iron deficiency
Acanthocyte (Spur cell)		RBCs demonstrating irregularly-spaced, spiny projections that vary in size and number No central pallor .	Abetalipoproteinemia Severe hepatic disease Myeloproliferative disorders MAHA Neuroacanthocytosis syndromes
Echinocyte (Burr cell)		RBCs have short and evenly-spaced, rounded projections surrounding the cell. Central pallor present	Uremia Heart disease Pyruvate kinase deficiency Stomach cancers Bleeding peptic ulcers
Bite cell		Red cells that appear to have bites taken out of them (Image A) Supravital stain reveals the presence of Heinz bodies--precipitated denatured masses of hemoglobin (Image B).	Disorders associated with Heinz body formation: Unstable hemoglobins Chemical poisoning G-6PD Hemolytic anemia associated with severe alcoholic liver disease