Normal Blood Smear

Note: healthy RBCs with central pallor, neutrophil and lymphocyte

Reticulocytes

Note: rounder, larger, no so much central pallor

Rouleaux Formation

Stacking of RBCs seen in inflammatory conditions (↑fibrinogen)

Hypochromic Microcytosis

DDx: iron deficiency anemia, anemia of chronic disease, thalassemias, sideroblastic anemia

Acanthocytes (spur cells)

Seen with liver cirrhosis, a-β-lipoproteinemia

Macrocytosis 

DDx: liver disease, alcoholism,  

With Megaloblasts in BM: B₁₂ or Folate deficiency

Echinocytes (burr cells)

Seen with uremia

Dacrocytes

Seen with: myelofibrosis, myleoproliferative disorders, pernicious anemia, thalassemia, some hemolytic anemias

Pappenheimer Bodies

(Iron inclusions)

Seen in sideroblastic and megalobastic anemias, post-splenectomy and some hemoglobinopathies

Target Cells

pretty indicative of Sickle Cell or thalassemia

Blister Cells

precursors to helmet cells? also found in Sickle Cell

Schistocytes

Due to shear stress → mechanical trauma

Spherocytes

Loss of membrane → sphere shape

Seen in: H.S., autoimmune hemolysis, burns, transfusion reactions...

Howell-Jolly Bodies

RBCs with nuclear chromatin (somewhat central?)

Seen in asplenic patients

Heinze Bodies

Note: peripheral location

Common with G6PDH deficiency

Bite Cell

What you get when macrophages bite out Heinze Bodies

Seen with G6PHD deficiency

Beta Thalassemia Smear

Note: poikilocytosis, microcytosis, hypochromia, presence of target cells

hypersegmented neutrophil

common sight in megaloblastic anemias

Megaloblasts

Note: megaloblasts live in bone marrow. This is a bone marrow aspirate. 

Iron Deficiency Smear

Note: pretty extreme anemia, microcytosis, hypochromic cells

Ring Sideroblasts

excessive iron accumulation in mitochondria

seen in Sideroblastic Anemia

NOTE: these are -blasts (precursors, in the marrow)

Aplastic Marrow

Note: not a lot of hematopoietic cells

Normal Bone Marrow

Note: ratio of about 1:1

fat cells:hematopoietic cells

Bone Marrow in Polycythemia

Note: whole lot of hematopoietic cells