Erythrocyte Inclusions

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Marjorie A. Spahn, MLS(ASCP); Marybeth Fannon, MA, MLS(ASCP)
Reviewer: Rory Huschka, M.Ed., MLS(ASCP) and Joshua J. Cannon, MS, MLS(ASCP)^CMSH^CM

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.

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Continuing Education Credits

P.A.C.E.® Contact Hours: 1 hour(s)
Florida Board of Clinical Laboratory Science CE Credit Hours -
General (Hematology): 1 hour(s)

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 clas...

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 th...
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)^CMSH^CM 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.

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