Hematology, quick reference 7 of 10
07 / 10 · Hematology
RBC morphology
Eight shape findings on a stained peripheral blood film
Assess red blood cell (RBC) shape where cells lie singly or just touch and normal central pallor remains visible. Thick areas distort shape and obscure pallor. Normal pallor occupies about one third of a cell's diameter.1
May-Grünwald Giemsa-stained blood films.2
Echinocyte
Short, evenly spaced projections. Often an artifact. Also seen in uremia. Acanthocytes have irregular projections.
Acanthocyte
Uneven projections of varied length. Severe liver disease and lipid disorders. Compare with regular echinocytes.
Spherocyte
Dense, no central pallor (single arrow). Immune hemolysis and hereditary spherocytosis. Thick areas hide normal pallor.
Elliptocyte
Elongated ovals (paired arrows). Hereditary elliptocytosis and iron deficiency. Large ovals suggest megaloblastic change.
Target cell
Stained center, pale ring, outer rim. Thalassemia, liver disease, and hemoglobin variants. Uneven distribution across the film suggests an artifact.
Stomatocyte
Slit-like central pallor. Hereditary stomatocytosis and liver disease. Slow drying can mimic this.
Teardrop cell
One tapered end (dacrocyte). Marrow fibrosis, marrow infiltration, and megaloblastic anemia. Artifact tails often point the same way.
Schistocyte
Angular or helmet-shaped fragment. Microangiopathic or mechanical damage. Follow counting and urgent-review policy.
Assess schistocytes by their number and the other film findings, alongside the blood count and hemolysis studies.3