Poikilocytosis Review Table

Cell Type Image Cellular Description Associated Diseases and Conditions

Teardrop cell Red blood cells (RBCs) are Myelofibrosis with myeloid
shaped like a teardrop with a metaplasia (MMM)
projection extending from one
end.

Spherocyte RBCs smaller than normal Hereditary spherocytosis

No central pallor Certain hemolytic anemias
Round rather than disc-shaped (eg, autoimmune hemolytic
anemia)
Severe burns
Target cell RBCs with characteristic bull's-
eye morphology due to
hemoglobin distribution
Sickle cell RBCs contain hemoglobin S.
Thorn or crescent-shaped
Hemoglobinopathies (e.g.,
sickle cell disease)
Certain thalassemias
Iron deficiency anemia
Splenectomy
Severe liver disease
Sickle cell anemia
Stomatocyte RBCs with thin, elongated area Hereditary stomatocytosis
of central pallor (slit-like, or Alcohol-related disease
coffee-bean-shaped on Liver disease
peripheral blood smears) Rh null phenotype
Three-dimensionally, RBCs are Artifact
cup-shaped.

Schistocyte RBC blood cell fragments or Severe burns

(fragmented red pieces Hemolytic uremic syndrome
cells) Vary widely in size and shape (HUS)
Microangiopathic hemolytic
anemia (MAHA)
Disseminated intravascular
coagulation (DIC)
Thrombotic
thrombocytopenic purpura
(TTP)
Ovalocyte RBCs are elongated-oval, cigar, Hereditary elliptocytosis
(elliptocyte) or pencil-shaped. Megaloblastic anemia
Myelophthisic anemia
Certain thalassemias
Severe iron deficiency

Acanthocyte RBCs demonstrating irregularly- Abetalipoproteinemia

(Spur cell) spaced, spiny projections that Severe hepatic disease
vary in size and number Myeloproliferative disorders
No central pallor MAHA
. Neuroacanthocytosis
syndromes
Echinocyte (Burr RBCs have short and evenly-
cell) spaced, rounded projections
surrounding the cell.
Central pallor present
Bite cell Red cells that appear to have
bites taken out of them (Image
A)
Supravital stain reveals the
presence of Heinz bodies--
precipitated denatured masses
of hemoglobin (Image B).
Uremia
Heart disease
Pyruvate kinase deficiency
Stomach cancers
Bleeding peptic ulcers
Disorders associated with Heinz
body formation:
Unstable hemoglobins
Chemical poisoning
G-6PD
Hemolytic anemia associated
with severe alcoholic liver
disease