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Hematology

Poikilocytosis Post-Splenectomy: Acanthocytes and Codocytes

Erythrocyte morphology after splenectomy: identification of codocytes and differential diagnosis of acanthocytes in a peripheral blood smear.

Tanya Stepanova Tanya Stepanova 1 min
Blood smear: marked poikilocytosis, codocytes, and echinocytes after splenectomy
Blood smear: marked poikilocytosis, codocytes, and echinocytes after splenectomy
Blood smear: target cells (codocytes) and spiculated forms of erythrocytes
Blood smear: target cells (codocytes) and spiculated forms of erythrocytes
Blood smear: field of view with poikilocytosis, codocytes, and platelet aggregation
Blood smear: field of view with poikilocytosis, codocytes, and platelet aggregation
Blood smear: neutrophil and various forms of altered erythrocytes in the center
Blood smear: neutrophil and various forms of altered erythrocytes in the center
Blood smear: erythrocyte with irregular processes in the center, circled
Blood smear: erythrocyte with irregular processes in the center, circled
Blood smear: acanthocyte with irregular cytoplasmic projections close-up
Blood smear: acanthocyte with irregular cytoplasmic projections close-up

👴🏻Patient: 69 years old. History: gastrosplenectomy. 🩸In peripheral blood: POIKILOCYTOSIS.

🔹Codocytes (target cells) Erythrocytes with a stained center where hemoglobin is concentrated, giving them a visual resemblance to a 🎯.

The presence of these erythrocyte forms may indicate liver diseases, hemoglobinopathies, IDA, thalassemia, and splenectomy.

TASK from a subscriber! What is located in the very center of the smear in photos 4-5? Choose one answer:

  1. Spherocyte with outgrowths like a “jellyfish”
  2. Echinocyte
  3. Acanthocyte
  4. Schistocyte

☝🏻The answer is in photo 6.

🙏 The publication was kindly provided by clinical laboratory diagnostics physician Tanya Stepanova, Volgograd.

What other erythrocyte forms did you see?

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