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Rbc inclusion ()))))
1.
2. P R E S E N T E D B Y G R O U P 6
P R E S E N T E D T O M I S S M E H R E E N
Red blood cell inclusion
3. Introduction
Inclusion bodies are those things that just appear in
cells and.. don’t really do anything. They’re just
included within the cell, for some purpose
Typically, inclusion bodies are nuclear or
cytoplasmic aggregates of stainable substance,
usually proteins
In RBC it is indication of some pathological
conditions
4. Introduction
These bodies are never enclosed by a membrane and
serve as storage vessels.
Glycogen, which is a polymer of glucose, is stored as
a reserve of carbohydrate and energy.
it is useful to understand each inclusion body that
can occur within a red blood cell.
5. Contt…
Following are the inclusion bodies with in RBC
Howell-Jolly Body
Heinz Body
Pappenhemier Body
Basophilic Stippling
Cabot Ring
6. Pappenheimer Body
Pappenheimer bodies are abnormal inclusions of
iron found inside RBC on a routine blood stain
Formed by phagosomes that have engulfed excessive
amounts of iron
Pappenheimer bodies are basophilic erythrocytic
inclusions usually Located at the periphery of the cell
They appear as dense, blue-purple granules within
the red blood cell
1 or 2 in number
7. Causes
Pappenheimer bodies are most likely caused by
accelerated red cell division or impaired hemoglobin
synthesis
8. Lab diagnosis
Can be visible with Wright or Giemsa stain
Prussian blue is more useful for identification and
differentiation
Cells containing Pappenheimer bodies can be confused
with late reticulocytes but it can not take prussian blue
stain
They also stain with Romanowsky stains because of co-
precipitation of ribosomes
Blood cell morphology
Reticulocyte count
MCV
Blood film
9. Diseases Associated
Splenectomy
Hemolytic Anemia
Sideroblastic Anemia
Megaloblastic Anemia
Hemoglobinopathies
The exact cause of Pappenheimer bodies in these
diseases is unknown.
10.
11. HOWELL-JOLLY BODIES
DEFINITION:Histopathologic findings of basophilic
nuclear remenants in circulating erythrocytes
TERMINOLOGY:Micronucleated Reticulocytes
SIZE:1 micronmeter in diameter
APPEARANCE:Small rounded,dense purple granules
13. Contt…
PATHOPHYSIOLOGY:
1. During Maturation in bonemarrow .Erythrocytes
normally expels nuclei
2. But sometimes small portion of DNA remains
14.
15. contt…
CONDITIONS:
1. Autospleenectomy due to sickle cell anemia
2. Hereditary spherocytosis
3. Megaloblastic anemia
4. Myelodysplastic syndrome .
5. Severe haemolytic anemia
6. Spleenectomy
DIAGNOSIS:
1. Peripheral blood smear
2. Wright stain (methylene blue + eosine)
3. Remenants of nucleus (DNA) observes
16. Heinz Body
• H E I N Z B O D I E S A R E I N C L U S I O N S
W I T H I N R E D B L O O D C E L L S C O M P O S E D
O F D E N A T U R E D H E M O G L O B I N .
• H E I N Z B O D I E S A P P E A R A S S M A L L R O U N D
I N C L U S I O N S W I T H I N T H E R E D C E L L
B O D Y .
17. Contt…
Heinz bodies are formed by damage and denaturing
to the hemoglobin component of red blood cells,
most commonly by oxidative stress, but also possibly
by genetic abnormalities in hemoglobin.
Typically, during oxidative damage to hemoglobin,
an electron is transferred from the hemoglobin to
oxygen, resulting in the formation of a reactive
oxygen species (ROS). This ROS can lead to severe
damage within the cells, and can even cause lysis of
the entire cell.
18. Contt…
The ROS denatures portions of the hemoglobin,
causing the to precipitate and produce Heinz Bodies,
which becomes an antigenic agent. Thus,
macrophages detect the antigen and remove the
damaged portions of the cell, its damaged membrane
and the denatured hemoglobin (now called the Heinz
Body).
21. Cabot ring
They are literally loop ,rings or figure 8 types
structure that are located with in the cytoplasm of
RBC.
They are typically colored red purple under the
Wright stain
They are quite rare
They are simple microtubular remnants of mitotic
tubules that are involve in mitosis
22. DISEASES ASSOCIATED WITH CABOT RING
MYELODYSPLASTIC SYNDROME
MEGALOBLASTIC ANEMIA
LEAD POISONING
HEAVY METAL POISONING
LIVER DISEASES
25. Basophilic Stippling
Basophilic stippling is also referred to
as punctuate *dots* basophilia
Diseases Associated:
can be divided into
1 fine basophilic stippling
polychromatophilia.
2 coarse *rough* basophilic stippling.
lead poisoning, and thalassemia
impaired hemoglobin synthesis
Stained by Wright stain
Editor's Notes
Heinz bodies irregular shape and size (elevation of platlets on electronic counters)
Increase low