Page 214 - Haematologica Atlas of Hematologic Cytology

Figure Transfusion dependent thalassemia thalassemia thalassemia thalassemia major Peripheral blood lm a a a a a a a a a a er er er sple- nectomy There are target cells cells which result from cells cells with a a a a a a dispropor onately large surface com- pared with with their volume leptocytes i i i i i i e e e e e e e e e e e e e e thin cells with with very large unstained central areas fragmented cells cells and peculiarly-shaped cells cells with bizarre shape shape a a a a a a a microspherocyte (bo om center) Erythroblasts are are numerous there are are also Howell-Jolly bodies bodies and Pappenheimer bodies bodies both prominent in in sple- nectomized pa ents Pappenheimer bodies bodies are are smaller than Howell-Jolly bodies bodies and are are composed of hemosiderin while Howell-Jolly bodies are nuclear remnants AB
Figure Transfusion dependent thalassemia thalassemia thalassemia thalassemia major ( ) Peripheral blood smear showing target cells cells cells cells hypochromic cells cells cells cells dacriocytes and many pit-cells/schistocytes ( ) In this case in addition to to target cells cells cells cells and and hypochromic cells acanthocytes echinocytes dacryocytes and and basophilic stippling are evident In homozy- gous gous and compound heterozygous -thalassemia marked to to extreme poikilocytosis may be present Irregularly contracted red red cells cells i i i i i e e e e e e e e e e e e red red cells cells smaller than normal and densely stained with irregular margins may also be observed Another frequent finding is is polychromasia generally due to to reticulocytosis In thalassemia an inade- quate reticulocytosis is is is associated with ineffective erythropoiesis 201