Erythrocyte Inclusions
Continuing Education Credits
This course describes and richly illustrates various erythrocyte inclusions, including basophilic stippling, Cabot rings, Pappenheimer bodies, siderotic granules, and Howell-Jolly bodies, making it productive for CE, exam reviewing, and cross training.
Objectives
- Identify erythrocyte inclusions that may be observed on a Wright or Wright-Giemsa stained peripheral blood smear.
- Identify erythrocyte inclusions that require staining methods other than Wright or Wright-Giemsa stain to be visualized on a peripheral blood or bone marrow smear.
- Discuss the composition and formation of various erythrocyte inclusions.
- Identify diseases or disorders associated with various erythrocyte inclusions.
Course Outline
- Introduction to erythrocyte inclusions
- What are Erythrocyte Inclusions?
- True or False: The presence of erythrocyte inclusions may indicate the presence of disease.
- Characteristics of polychromatophilic red cells (Reticulocytes)
- Reticulocytes
- Normal Erythrocytes
- Polychromatophilic Red Blood Cells (RBCs)
- Stress Reticulocytes
- Which of the following statements characterize a reticulocyte?
- While performing a peripheral blood smear review, you observe the cells indicated by the arrows on this Wright-Giemsa stained slide.How would you classify these cells?
- Characteristics of Basophilic Stippling
- Basophilic Stippling
- Fine Basophilic Stippling
- Coarse Basophilic Stippling
- What is the composition of the granules associated with basophilic stippling?
- In which of the following disorders would you probably observe coarse basophilic stippling on a Wright-stained peripheral blood smear?
- Characteristics of Howell-Jolly Bodies
- Howell-Jolly Bodies
- Examples of Howell-Jolly Bodies
- Howell-Jolly Body in Nucleated Red Cell
- What is the composition of Howell-Jolly bodies?
- If present, how many Howell-Jolly bodies are usually seen within a given erythrocyte?
- In which of the following conditions would you expect to find Howell-Jolly bodies?
- What abnormality is present in this slide?
- Characteristics of Pappenheimer bodies and Siderotic granules
- Pappenheimer Bodies
- Pappenheimer Bodies, continued
- Pappenheimer Bodies, continued
- Basophilic Stippling contrasted with Pappenheimer Bodies
- Howell-Jolly Bodies and Pappenheimer Bodies
- Comparison of Erythrocyte Inclusions
- Siderotic Granules
- Siderocytes and Ringed Sideroblasts in Bone Marrow
- Siderocyte
- Sideroblast
- Match the descriptions below with the erythrocyte inclusions from the drop down box that they describe. The descriptions refer to the appearance of the inclusions on a Wright-stained peripheral blood smear.
- Which of the following is not present in normal bone marrow and would be associated with a disease or disorder?
- True or False: The inclusions indicated by the arrows on this Wright-Giemsa stained peripheral blood smear are likely Pappenheimer bodies.
- True or False: The cell indicated by the arrow in this Prussian-blue stained bone marrow smear is a ringed sideroblast.
- Characteristics of Cabot Rings
- Cabot Rings
- Cabot Rings, continued
- Cabot Rings, continued
- Which of the following statements best describes the appearance of Cabot rings?
- In which of the following conditions might Cabot rings be observed in erythrocytes on a Wright-stained peripheral blood smear?
- Characteristics of Heinz Bodies
- Heinz Bodies
- Heinz Bodies, continued
- Heinz bodies are composed of which of the following?
- Heinz bodies can be found in which of the following disorders?
- Malaria and Malarial Parasites
- References
- References
Additional Information
Level of Instruction: Intermediate
Intended Audience: Medical laboratory personnel, including medical laboratory scientists, medical technologists, and medical laboratory technicians. This course is also appropriate for medical laboratory students and pathology residents.
Author Information: Betty Smith, MLS(ASCP) and Jaimy Hill, MLS(ASCP) developed this course. It was updated by Education Materials for Health Professionals, Inc., under the supervision of Marjorie Spahn MLS(ASCP). It was reviewed and adapted for online use by Paul Fekete, M.D. fellow C.A.P.
Reviewer Information:
Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor of Science and Master of Science in Medical Laboratory Science from Thomas Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist and Specialist in Hematology certifications through the ASCP Board of Certification. He was a professor at Thomas Jefferson University for seven years before transitioning into his current role as Education Developer at MediaLab. His areas of expertise and professional passions include clinical hematology and interprofessional education.
Rory Huschka, M.Ed., MLS(ASCP), has over 20 years of combined experience as a medical technologist, technical supervisor, professor, and manager. He is a former program director of medical laboratory science and technician programs. He is currently an Account Executive at MediaLab. Rory holds a BS degree in medical technology from North Dakota State University and a master's degree in educational leadership.
Course Description: This course identifies, describes, and illustrates red blood cell inclusions as they are observed on Wright or Wright-Giemsa-stained peripheral smears. Additional staining procedures that make possible or enhance identification of some erythrocyte inclusions are also discussed. Numerous practice and exam questions reinforce visual recognition skills.
Copyright: This revised course was originally part of a series of courses adapted for the web by MediaLab Inc. under license from Educational Materials for Health Professionals Inc. Dayton OH, 45420. Copyright EMHP Inc.