RBC Inclusions Hematology Review 303
INCLUSION STAIN DESCRIPTION EXPLANATION SIGNIFICANCE CONDITIONS
Basophilic
stippling
Howell-Jolly
bodies
Cabot rings
Pappenheimer
bodies
Wright’s & new
methylene blueWright’s & new
methylene blueWright’sWright’s (siderotic
granules with
Prussian blue stain)Multiple, irregular
purple inclusions
evenly distributed
in cellRound, purple,
1–2 μm in
diameter. Usually
only 1 per cellReddish purple
rings or figure-8sSmall purplish blue
granules. Vary in
size, shape, #.
Usually in clusters
at peripheryAggregation of RNA
(ribosomes)Nuclear remnants
(DNA)May be part of mitotic
spindle, remnant of
microtubules, or
fragment of nuclear
membraneIron particlesCoarse: exposure
to lead. Fine:
young RBCUsually pitted by
spleen. Seen with
accelerated or
abnormal
erythropoiesisRapid blood regen-
eration, abnormal
erythropoiesisFaulty iron
utilizationExposure to lead,
accelerated or abnor-
mal hemoglobin
synthesis, thalassemiaPostsplenectomy,
thalassemia, hemolytic
& megaloblastic
anemias, sickle cell
anemiaMegaloblastic anemia,
thalassemia,
postsplenectomySideroblastic anemias,
postsplenectomy,
thalassemia, sickle
cell anemia,
hemochromatosiscontinued...