Required section · Section 4 of 6

Guided example

Matched routine fields show a solitary round, sharply bordered Wright-Giemsa body and peripheral angular granular clusters. The first observation is consistent with a Howell-Jolly body. The angular clusters are suspicious for Pappenheimer granules, but routine appearance alone does not prove iron.

Matched Perls fields have valid-positive and valid-negative controls. The patient granular clusters stain blue while the solitary round body does not; report one example: ‘Peripheral iron-containing granules supported by Perls stain.’ Do not turn that material result into a disease diagnosis.

If controls failed, no patient Perls interpretation could be released: correct the control problem, repeat the stain, or escalate. Supravital staining is not ordered here because no bite/blister pattern with oxidative context is described.

Image and stain observations from the case.
Preparation	Observation	Bounded interpretation
Wright-Giemsa, matched field	Solitary round sharply bordered body	Consistent with Howell-Jolly body; morphology only
Wright-Giemsa, matched field	Peripheral angular granular clusters	Suspicious for Pappenheimer granules; Perls required
Perls, valid controls	Clusters stain blue; solitary body unstained	Iron-containing granules supported by Perls

Knowledge checks

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Knowledge check 1

Which interpretation matches the case?

Choose one option.

Round bodies are consistent with Howell-Jolly bodies, and Perls-positive angular clusters support Pappenheimer bodies.

The film proves functional asplenia.

The case demonstrates Heinz bodies.

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