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Case 44 - Discussion

Hematopathology Case


The peripheral blood smear shows both basophilic stippling and Howell-Jolly bodies.


Basophilic stippling

  • Morphology: uniform and fine blue granule, evenly dispersed

  • Content: aggregated ribosomes (rRNA)

  • Causes:

    • Lead poisoning, porphyria

    • Hemoglobinopathies, thalassemia

    • Pyrimidine 5 nucleotidase deficiency, in up to 5% of RBCs

    • Myelodysplasia

    • Infection

    • Sideroblastic anemia

  • Differential: Peppenheimer bodies: multiple blue dots, irregular size, irregularly located or in small cluster; contents, iron

Howell-Jolly bodies

  • Morphology: single, dense, blue dot

  • Content: nuclear DNA remnant

  • Causes:

    • Post-splenectomy

    • Functional asplenia

    • Megaloblastic anemia

    • Myelodysplasia