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Blood Film

Red Cell Inclusion Bodies



  • Red blood cell inclusion bodies are pieces of stainable material within red blood cells, mainly due to retained remnants of cellular components.

Howell Jolly Bodies

  • Howell Jolly bodies are basophilic inclusions within the cytoplasm, made up of DNA fragments.
    • Howell Jolly Bodies
    • Howell Jolly Bodies
  • Howell Jolly bodies are classically seen following splenectomy, though may also occur in patients with any cause of hyposplenism.
    • Causes of Howell Jolly Bodies

    • Post-splenectomy
    • Functional hyposplenism - sickle cell anaemia, liver cirrhosis, SLE, rheumatoid arteritis, coeliac disease, inflammatory bowel disease, splenic artery / vein thrombosis, amyloidosis, sarcoidosis 

Basophilic Stippling

  • Basophilic stippling is the presence of irregular basophilic granules, made up of RNA fragments.
    • Basophilic Stippling
    • Basophilic Stippling
    • Causes of Basophilic Stippling

    • Thalassaemia
    • Sideroblastic anaemia
    • Unstable haemoglobins
    • Myelodysplastic syndromes
    • Heavy metal poisoning - lead, arsenic, mercury

Pappenheimer Bodies

  • Pappenheimer bodies are basophilic inclusions seen in the periphery of red blood cells, made up of ferritin.
    • Pappenheimer Bodies
    • Causes of Pappenheimer Bodies

    • Post-splenectomy
    • Sideroblastic anaemia
    • Lead poisoning

Cabot Rings

  • A cabot ring is a basophilic loop seen within red blood cells, made up of mitotic spindle remnants.
    • Cabot Rings
    • Causes of Cabot Ring

    • Megaloblastic anaemia - B12 / folate deficiency, drugs
    • Myelodysplastic syndrome
    • Myelofibrosis
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