Small, densely-stained with several irregular projections.

Seen in severe liver disease, alcoholic cirrhosis, and chronic starvation.

Cell has vacuole on one side. Caused by removal of inclusions, similar to bite cells.

Seen in G-6-PD deficiency and hemoglobinopathies.

Cell has evenly distributed “bumps” along surface. Central pallor is still visible.

Seen in Uremia, Renal insufficiency, Cirrhosis, Severe dehydration, Burns, etc.

Can be artifactual due to slide preparation. Suspect when found in large numbers or only in certain areas of the slide.

Ovalocytes are typically more egg shaped while elliptocytes are skinner and more pencil shaped. Terms are often used interchangeably.

Macroovalocytes are seen in megaloblastic anemias.

Elliptocytosis can be hereditary.

Otherwise seen in myelofibrosis, Iron Deficiency Anemia, and Thalassemia.

Variation in cell shape.

Thin, crescent-shaped cell with pointed ends, usually lacking central pallor.

Seen in patients with Hgb S (sickle cell)

Small, spherical RBCs that stain densely and lack central pallor.

Seen in Hereditary spherocytosis, immune hemolytic anemia, post-transfusion, and severe burns.

May appear as artifact in thinner area of the slide where RBCs have cobblestone effect.

Cell looks like target or bullseye. Ring around central area of hemoglobin should be fairly clear. If it looks “blurry,” the target cell may be artifactual due to slow slide drying or excess EDTA.

Seen in Iron Deficiency Anemia, Thalassemia, Liver disease, & Hemoglobinopathies.

Teardrop or pear-shaped cell. Tail should be blunt; Sharp projections all going in the same direction are artifactual from slide-making.

Seen in myelofibrosis, pernicious anemia, hemolytic anemia, and Thalassemia.

Fragmented cells with several different subcategories such as helmet cells (AKA bite cells). Cell lacks central pallor.

Seen in Disseminated Intravascular Coagulation (DIC), Thrombotic Thrombocytopenic Purpura (TTP), Microangiopathic Hemolytic Anemias.

Helmet Cells are characteristic of G-6-PD deficiency.

Cell has central slit, making it look like a mouth. If slits are all oriented in the same direction, it is likely artifactual from slow slide drying.

Can be hereditary or seen in liver disease or alcoholism.