Page 212 - Haematologica Atlas of Hematologic Cytology

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Figure 1 Sic le le cell cell cell cell anemia ( ( and and ) ) Peripheral blood smear from a a a a a a a a a a a a pa ent with homozygosity for hemoglobin S S S S variant (HbS) showing dense cells cells cells deep staining irreversibly sickled cells cells cells hypochromic cells cells cells anisocytosis and and and and poikilocytosis with with acanthocytes and and and echinocytes HbS HbS is is is is insoluble in in in in in in in in condi ons of of hypoxia and and and tends to to to crystallize causing the sickle-like appearance of of red cells cells i i i i i i i i i i i i i i i e e e e e e e e e e e e e e e e e elongated cells cells with with pointed ends AB
Figure Sic le le le le cell cell cell cell cell (S ) ) anemia ( ( ( ) ) A nucleated red blood cell cell cell cell cell is evident in in addi on on to an an an an irreversibly sickled cell cell cell cell cell dense cells cells cells hypochromic cells cells cells acanthocytes and echinocytes In most adults features of func onal asplenia (Howell-Jolly bo- dies dies or as as as as in in in this case Pappenheimer bodies-arrows) are also observed ( ( ( ) ) ) Note the the ellip cal SCs SCs (reversibly sickled cells) SC SC SC trait i i i i i i i i i i i i i i i i i i i i e e e e e e e e e e e e e e e e e e e e e the the heterozygous state is is is is instead associated with mild anisopoikilocytosis and only occasional SCs SCs AB
Figure Hemoglobin S S S variant (HbS)/ thalassemia ( ( ( ) ) ) Peripheral blood lm showing irreversibly sickled cells cells cells cells boat-shaped cells cells cells cells cells target cells cells cells cells cells hypochromic cells cells cells cells cells acanthocytes and and echinocytes ( ( ( ) ) ) Sickling test reveals the the sickle sickle cell cell cell cell cell forma on on on on as a a a a a a a a a a a a a a a consequence of of reduc reduc on on on on and and polymeriza on on on on of of HbS inside the the red red red blood cells cells cells cells induced “in vitro” by a a a a a a reducing agent (sodium metabisul te) 199