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(a) These will have a smaller surface and thus reduced ability to carry O 2.
(b) Associated with hemolytic anemia and hereditary spherocytosis.
(4) Bizarre forms:
(a) Irregularly contracted cells.
(b) Indicative of disease process.
(5) Crenated cells:
(a) Mechanically produced irregularities due to improper slide preparation or an old blood
sample.
(b) Not reported.
c. Hemoglobin variations:
(1) Hypochromasia:
(a) Decreased hemoglobin concentration.
(b) Found in iron deficiency anemia
(2) Target cells:
(a) An abnormally thin erythrocyte with a centrally stained area.
(b) They are associated with liver disease and certain hemoglobinopathies.
(3) Polychromasia: immature cytoplasm (RNA present).
d. Inclusions:
(1) Basophilic stippling:
(a) Heavy metal poisoning.
(b) Certain anemias and alcoholism.
(2) Howell-Jolly bodies:
(a) Nuclear remnants less than 1 micron in diameter.
(b) Stain dark violet with Wright’s stain.
(c) Are implicated in certain anemic conditions and other forms of nuclear maturation defects.
(3) Cabot’s rings:
(a) Nuclear remnants.
(b) Severe pernicious anemia (B-12 deficiency).
e. Differences in coloration:
(1) Hypochromic:
(a) A decrease in the color of the RBC indicating a decrease in their hemoglobin content.
(b) May be found in iron deficient anemia and other anemias.
(2) Hyperchromic:
(a) Deep coloration of RBCs.
(b) Probably a problem with the stain.
f. Rouleaux formations: A phenomenon where the erythrocytes adhere to one another presenting a
“stack of coins” appearance. It occurs in conditions characterized by increased amounts of
fibrinogen and globulin.
- Record findings as:
a. Normal: (N/N)
(1) Normocytic: normal cell size and shape.
(2) Normochromic: normal hemoglobin content and coloration.
b. Abnormal:
(1) Use the specific terminology for the noted abnormality.
(2) Grade the degree of all abnormalities.
(a) Slight: abnormal forms seen intermittently.
(b) Moderate: few abnormal forms seen in most fields.
(c) Marked: several abnormal forms seen in each field.
Lab Procedure: WBC Count on Whole Blood
18D Skills and Training ManualWhen: You need to determine the number of white blood cells (WBC) in a blood sample.