The only treatment required is oral administration of iron salts in some palatable form, such as ferrous sulfate. Target Cells (Codocytes): erythrocytes that are thinner than normal which show a peripheral rim of hemoglobin with a dark central hemoglobin-containing area. l Found in iron deficiency, thalassemia, sideroblastic anemia. Iron Deficiency. Reexposure to oxygen causes immediate reversion to the discoidal form. Ovalocytes are red blood cells that have an oval shape rather than the usual round doughnut shape. These are made in your bone marrow, where they grow for about 7 days before they are released into your bloodstream. This is the American ICD-10-CM version of R71.8 - other international versions of ICD-10 R71.8 may differ. 1+ polychromasia if: a. These types of conditions can result in increased blood loss and the destruction of RBCs, which in turn can increase RBC production. However, almost all types of cancer treatment affect both cancer cells as well as healthy cells. The four most common RBC inclusions are Howell-Jolly bodies, Pappenheimer bodies, Heinz bodies and basophilic stippling. Check the full list of possible causes and conditions now! Sideroblastic Anaemia. Although it is not necessarily less common now, there is no doubt that it is less severe in Europe and North America than it once was. Codocytes, or Target Cells, resemble targets, a bullseye or Mexican hats. Thalassaemia. The cause of hypochromia should be evaluated by your health care provider. It can detect parasites like malaria parasites as well. Download scientific diagram | (A) Peripheral smear showing anisocytosis, poikilocyosis, hypochromia and polychromasia. For example, iron deficiency is the most common cause of microcytic anemia. Some causes are temporary and will go away, while some causes are chronic and may be lifelong. Polychromasia refers to macrocytic (large) red blood cells with a bluish tinge, due to residual RNA. Your doctor comes to know about it with a lab test. Iron is also available in liquid form for infants and children. Initially, iron deficiency anemia can be so mild that it goes unnoticed. A image of a CLL peripheral blood smear showing polychromasia in numerous red blood cells. RDW 14.6 Aniso Few Ovalocyte. Bain BJ. With this disease, RBC turnover is most affected by hemolytic anemia. Polychromasia. They are present along with normal or abnormal mature RBCs. SEUC; urea: 20 mg/dl (2.5-6.4 mg/dl). This condition can happen when your body makes red blood cells in places other than your bone marrow because your bone marrow has been infiltrated or invaded by materials that shouldnt be there and isn't working correctly. Thanks to improved treatments, people with PNH now have near-standard life expectancy. While the many complications of the disease can be treated and pain relieved, there is no treatment to reverse or prevent the actual sickling process. Signs of Hypochromia; An increase in central pallor > . l Pale staining of RBC due to thin cell and low Hb conc. Your kidneys produce a hormone called erythropoietin that tells your bone marrow to make more blood cells. Since the first characterization of the nature of Hb S by American chemist Linus Pauling and his associates in 1949, more than 100 variant hemoglobins have been identified. Children aged 6 months to 6 years are considered anemic at Hb levels less than 11 g/dL, and children aged 6-14 years are considered anemic when Hb levels are less than 12 g/dL. But as the body becomes more deficient in iron and anemia worsens, the signs and symptoms intensify. These cells are likely reticulocytes, which are immature non-nucleated red cells which have only just extruded their nuclei. Red cell volume distribution curves have been used to measure microcytosis and anisocytosis in normal subjects, blood donors and patients with iron deficiency anaemia. This means that your red blood cells (RBCs) are of mixed sizes. Hemoglobin is composed of a porphyrin compound (heme) and globin. Fatigue and tiredness occur due to less concentration of blood in body. .This is protected and monitored under Digital Millennium Copyright Act. This usually occurs when there is not enough of the pigment that carries oxygen ( hemoglobin) in the red blood cells. Hypochromia is often seen with microcytosis and thus have similar . a. Hemorrhaging can be external, or outside of the body, from an injury or wound. Hypochromic microcytic anemias, characterized by the presence in the circulating blood of red cells that are smaller than normal and poorly filled with hemoglobin, fall into two main categories. A number of toxic drugs are oxidants or are transformed into oxidizing substances in the body. Piles and hemorrhoids are another cause of this condition. This decrease in redness is due to a disproportionate reduction of red . These types of cancers are likely to show polychromasia during blood testing. There, the lab technician looks at it under a microscope. Not all cancers affect RBC turnover. These cells, which remain after ejection of the nucleus from the orthochromatic erythroblast are slightly larger than mature erythrocytes. ", Johns Hopkins Medicine: "Hemolytic Anemia. Symptoms of paroxysmal nocturnal hemoglobinuria include: If you have any of these symptoms, your doctor will likely want to run some blood tests to determine if you have any of the associated underlying conditions. The actual disease is less common (about 1 in 500 black Americans). A blood smear is used to evaluate your red blood cells (RBCs), noting any abnormal differences in size, shape, or other physical appearances such as that seen in various anemias, sickle cell disease, Thalassemia, or other disorders. 7 Infection. Which diseases cause polychromasia? These tetramers are ineffective in delivering oxygen and are unstable. A long-recognized type of hemolytic anemia is that associated with the transfusion of incompatible red cells. American Society of Hematology: "Blood Basics. Iron deficiency is common in infancy and childhood because demands are great for the ever-expanding pool of circulating hemoglobin in the growing body, and in pregnancy when the fetus must be supplied with iron. So polychromasia is a finding that helps to detect conditions or diseases causing a fault in these mechanisms. Thalassemia major Cancer in the bone marrow. . Hemoglobin is the part of red blood cells that gives blood its red color and enables the red blood cells to carry oxygenated blood throughout your body. Your red blood cells are the cells in your blood that carry oxygen to the rest of your body. Hypochromic microcytic anemias, characterized by the presence in the circulating blood of red cells that are smaller than normal and poorly filled with hemoglobin, fall into two main categories. Younger red blood cells produced in bone marrow undergo development there. The term used to indicate a normal color or central pallor (i.e., normal hemoglobin content) is normochromic, Disseminated intra-vascular coagulopathy (DIC), Thrombotic Thrombocytopenia purpura (TTP). In lead poisoning, the presence of basophilic stippling and polychromasia . Hypochromic anemia can lead to pica (a condition in which the patient feels craving or the non-food items like paper, paint, dirt etc. Rouleaux formation: describes an aggregation of erythrocytes that are aligned one upon the other, resembling stacks of coins, Agglutination of red cells: is caused by agglutinins and resembles Rouleaux but is more irregular with round clumps rather than linear Rouleaux. Red blood cell inclusions result from specific circumstances or conditions discussed below. Peripheral blood film - a review. When Hypochromasia is caused by the parasitic infections then you should go for a Homeopathic treatment called Cina, which is very effective in treating this.. 4. Iron deficiency is the most common cause of microcytic anemia. Remember that polychromasia does not occur instantly after hemorrhage or hemolysis but takes 2 to 4 days to increase the number of polychromatophilic erythrocytes in peripheral blood and may not exceed the reference interval or achieve maximum values for 5 to 7 days. Clitoromegaly - Pictures, Size, Symptoms, Causes, Treatment, Lymphocele on Penile shaft & groin Pictures, Treatment, Diagnosis, What is Ptyalism - Definiton, Symptoms, Causes, Treatment, What is Skeeter syndrome - Definition, Symptoms, Causes, Treatment, Hypopyon - Definition, Symptoms, Causes, Treatment, What is Hyposmia - Definition, Symptoms, Causes, Treatment, Hyperfixation - Meaning, Definition, Anxiety/Depression. Hypochromasia is usually classified in several levels which are coded as 1+, 2+ and 3+. When you have polychromasia, its important to find the underlying cause so that you can receive treatment right away. Anemia is a very common condition that is widespread in the human population. So polychromasia is a finding that helps to detect conditions or diseases causing a fault in these mechanisms. Symptoms may include jaundice, fatigue, gallstones, high blood pressure, and/or a pronounced forehead. .This is protected and monitored under Digital Millennium Copyright Act. The underlying causes may need specific treatment aimed to cure them. At first anemia can be so mild that it goes unnoticed. To prevent iron deficiency anemia in infants, feed your baby breast milk or iron-fortified formula for the first year. Sideroblastic anemia, characterized by the presence in the bone marrow of nucleated red blood cells, the nucleus of which is surrounded by a ring of iron granules (ringed sideroblasts) and by a proportion of small, pale red cells in the blood, is of unknown cause and difficult to treat. The extra non--chains may combine into tetramers to form 4 (hemoglobin H) or 4 (hemoglobin Bart). Tachycardia occurs and the heart beat increases up to 100 beats per minute. Or, the blood may be examined by an automated machine. A pale unstained ring containing less hemoglobin separates the central and peripheral zones and gives the cell a target appearance. Polychromasia: Changeable terms used to indicate the increased presence of non-nucleated immature erythrocytes (Polychromatophilic erythrocytes) that contain residual RNA which gives a blue-gray tint to the red cells. Dr. Michael Dugan answered. It is an indication of various diseases. The three types of anisocytosis are: Anisocytosis with microcytosis - The red blood cells are unusually small in size. The immature RBC are blue because they contain moderate to large amounts of RNA (ribosomes, polyribosomes) which offsets the red of hemoglobin, imparting a purple color to the cells. Spherocytes can have an elevated MCHC. This condition can occur because of many causes. Red cells are formed in the liver at a young age and bone marrow takes over as you grow older. This is typically from the normal pink to the to the purplish colour which results from the uptake of eosin by haemoglobin and basic dye by residual RNA. Hypochromic: Erythrocytes that demonstrate a central pale area that becomes larger and paler as the hemoglobin content diminishes. During the test, a pathologist smears a slide with a sample of your blood and then stains the slide to view the different types of cells within the sample. In erythroblastosis fetalis (hemolytic disease of the newborn), the destruction of fetal blood by that of the mother may be due to Rh or ABO incompatibility. Hypochromic RBC. Red blood cells carry oxygen to the bodys tissues. Circulating red blood cells (RBCs) contain a protein known as hemoglobin, that protein has four polypeptide chains and one heme ring that contains iron in reduced form. Anemia is defined as the reduction in circulating red-cell mass below normal levels. (In doubtful cases, it is wise to compare the staining of the . In the male there is virtually no further need for iron. Polychromasia is a feature of immature anucleate erythrocytes (which are also aggregate reticulocytes) in the blood. In normal hemoglobin the order in which the amino acids follow one another in the polypeptide chain is always exactly the same. l Reticulocytes with residual RNA have affinity for basic components of stain (blue) l Found in response to blood loss, haemolysis or haematinic therapy. These cells are stained with Brilliant Cresyl Blue stain which stain Hemoglobin H bodies composed of beta globin chains in tetrads. The Polychromasia is a type of condition in which the red blood cells inside the body start turn grayish blue in color. Most defects have to do with production and processing of the RNA from the -gene; in -thalassemia, by contrast, the gene itself is deleted. RBC populations with a normal MCHC value are normochromic. . Injury may be accidental, as with moth ball (naphthalene) ingestion in children, or it may be the undesirable effect of a drug used therapeutically. 1-3 polychromatc cells are found per microscopic feld b. However, its important to keep in mind that polychromasia isnt the only way to diagnose these conditions, and therefore your doctor may not even mention it upon diagnosis. The most common causes of megaloblastic, macrocytic anemia are deficiency or defective utilization of vitamin B12 or folate. Hypochromia usually occurs when there is not enough of the pigment that carries oxygen (hemoglobin) in the red blood cells. 2005-2023 Healthline Media a Red Ventures Company. This results in a moderately severe anemia. These are seen in the following conditions: Disseminated Intravascular Coagulation (DIC), Consequence of an artificial mechanical heart valve, Hemolytic Uremic Syndrome (HUS), a complication of stool pathogen E.coli 0157:H7 (Enterohemorrhagic E. coli), which damages the kidneys, Multiple Myeloma (MM, a type of blood cancer), Inflammatory and Connective Tissue Disorders, Hereditary Pyrimidine 5'-Nucleotidase Deficiency, Iron-overloading disorders (Hereditary hemochromatosis), Sideroblastic anemia (Congenital or Acquired), Refractory Anemia with Ringed Sideroblasts (RARS), In this type, 15% or more of RBC precursors are ringed sideroblasts, Bone marrow: erythroid hyperplasia, <5% myeloblasts, iron overload, and hepatosplenomegaly, Collecting & Processing of Blood: Pre-Analytical, The Complete Blood Count (CBC) and Differential, Red Blood Cell Inclusions and Abnormalities, White Blood Cell Inclusions and Abnormalities, 3-20 spicules with narrow bases that are distributed unevenly, seen in older blood cells or older samples, found in post-splenectomy states very commonly, always associated with pathological conditions, large numbers seen in abetalipoproteinemia or advanced liver disease, cell membrane damaged due to a decrease in membrane cholesterol, severe liver disease (hepatitis, ascites, cirrhosis, cancer, gallstones, toxicity, etc), Congestive splenomegaly (enlarged spleen), I see these a lot in organ failure, hypoxemia, respiratory distress, liver failure, uremia (kidney problems) and renal failure, low levels of magnesium and/or low levels of phosphate (decreased Mg/Phos on Chemistry tests), Increasedconcentrations of globulins or paraproteins, Clumping may be seen in antigen-antibody reactions (such as a transfusion reaction), Precipitated hemoglobin or denatured hemoglobin occurs, Usually a defect of an RBC enzyme in which a Heinz Body is removed by the spleen, so the cell looks like it's had a "bite" taken out of it, A pseudo-vacuole in the RBC membrane is formed by the disruption of fibrin, Pelger-Huet cell with agranulation and vacuoles, Anisocytosis with schistocytes, bite cells, macrocytes, microcytes, rbc aggregation, hypochromia, ovalocytes, one cell with Pappenheimer bodies. High level of circulating acute-phase proteins. Hematocrit is the most commonly used metric. Polychromasia & anisocytosis--are they bad? 1. (1) Normocyte - 6~8 - MCV 80~100fL - - - - - (2) Microcyte - 6 - MCV 80fL - - - - . At that time, theyll be able to detect polychromasia on a blood smear if its present. Fatigue and tiredness occur due to less concentration of blood in body. If it is not treated, this can lead to a disorder called iron deficiency anemia. In such cases, polychromasia becomes a side effect of the treatment rather than a sign of the disease. Treatment for polychromasia depends on the type of blood disorder thats causing it. You asked if hypochromic cells are normocytic - and for the . Before we start with the abnormal morphologies, lets talk about normal morphology of Red Blood Cells. The defect in thalassemia may involve the -chains of globin (-thalassemia), the -chains (-thalassemia), the -chains (-thalassemia), or both - and -chain synthesis. The red blood cells produced are microcytic and hypochromic. Category: Hemoglobinopathies So see your doctor for a diagnosis rather than taking iron supplements on your own. The thalassemias are another group of inherited disorders in which one or more of the polypeptide chains of globin are synthesized defectively. This happens when red blood cells are immature because they were released too early from your bone marrow. Antibodies to the substances alpha- and beta-isoagglutinin, which occur naturally in the blood, destroy the donor red cells when incompatible blood is given by transfusion. Hemolytic anemia can be inherited, meaning you had it when you were born, or acquired, which means you developed it later in life. A blood smear tells your doctor about the different types of cells and the amounts of each that are in your blood., A peripheral blood smear tells how many red blood cells, white blood cells, and platelets are in your blood. They are released to blood when they are mature enough. However, left untreated, iron deficiency anemia can become severe and lead to health problems, including the following: To diagnose iron deficiency anemia, your doctor may run tests to look for: If your bloodwork indicates iron deficiency anemia, your doctor may order additional tests to identify an underlying cause, such as: Your doctor may order these or other tests after a trial period of treatment with iron supplementation. Anemia is recognized as a low hematocrit, hemoglobin, or red blood cell count value. Fortunately, most variant hemoglobins are not sufficiently affected to alter their function, and therefore no observable illness occurs. Polychromasia. (B) Cation-exchange HPLC analysis of patient's blood sample showed two . In th. Poikilocytosis & Polychromasia in Peripheral Blood Smear Symptom Checker: Possible causes include Congenital Dyserythropoietic Anemia Type 1B. numerically (plus) from 1+ to 4+, others used descrip-tive terms, such as slight (few), moderate, or marked, and/or 'rare' or 'occasional'. Study with Quizlet and memorize flashcards containing terms like 1. A high percentage of polychromatophilic cells (reticulocytes) may result in an increased MCV and decreased MCH or MCHC. A minor fraction of normal adult hemoglobin consists of Hb A2, which contains - and delta- (-) chains. Red blood cells stick together in clumps due to proteins called agglutinins. Polychromatophilia (polychromasia) refers to an increase in the number of younger RBCs (retculocytes) with incomplete hemoglobinizaton. Underlying conditions that cause polychromasia, ncbi.nlm.nih.gov/pmc/articles/PMC4415389/, sciencedirect.com/topics/medicine-and-dentistry/polychromasia, seattlecca.org/diseases/blood-disorders/treatment-options, hopkinsmedicine.org/kimmel_cancer_center/types_cancer/paroxysmal_nocturnal_hemoglobinuria_PNH.html, urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=160&ContentID=34, Taking Control of Paroxysmal Nocturnal Hemoglobinuria, What You Need to Know About Paroxysmal Nocturnal Hemoglobinuria, Your FAQs Answered: What is Paroxysmal Nocturnal Hemoglobinuria (PNH), occurs due to an increased destruction of RBCs, causes an increased turnover of RBCs, can cause hemolytic anemia, blood clots, and bone marrow dysfunction the latter possibly bringing on early release of RBCs, symptoms of hemolytic anemia (listed above). Inherited anemia happens when your parents pass down the gene for the disease to you. If a doctor has noted that you have polychromasia, there are several underlying conditions that are most likely the cause. Polychromasia means multi coloured red blood cells in your blood. There are two principal causes of hemolytic anemia: (1) inherently defective red cells and (2) an environment hostile to red cells. Generally, youll start to feel better after a week or so of treatment. It may be so mild as to pass unnoticed for years, but it may suddenly become severee.g., when an incidental respiratory infection briefly suppresses the accelerated production of red cells necessary to meet the constantly increased rate of their destruction. They are exemplified by diseases in which the cell membrane is weakened, cell metabolism is defective, or hemoglobin is abnormal. Thalassemia major (Cooley anemia) is characterized by severe anemia, enlargement of the spleen, and body deformities associated with expansion of the bone marrow. 3. Polychromasia is a lavender-bluish color to RBC's due to RNA retained in larger, immature cells (macrocytes). Acquired hemolytic anemia can be caused by: Hemorrhage. A high RDW may be the only indication of simultaneous microcytic and macrocytic disorders; such a pattern may result in a normal MCV, which measures only the mean value. Deficiency results if the dietary supplies of iron are insufficient to meet the needs; if absorption is faulty, as in malabsorption disorders; or if blood loss is occurring. It is characterized by the presence of red cells that appear small, stain densely for hemoglobin, and look nearly spherical. Microcytosis: abnormally small erythrocytes (i.e., less than 6 in diameter). Hyperneb 3% respule (3% Normal saline) for nebulization, Polychromasia: meaning, causes, and treatment, RESPISTRONG: A RESPIRATORY IMMUNITY PROBIOTIC, Weight Gain After Stopping Breastfeeding: Causes And Tips To Avoid It, Bhole Children Clinic and vaccination center, Pediatrician, Ravet, Everything about vaccination you need to know, High-Protein Meals: The Science Behind Whats On Your Plate, Back Pain During Breastfeeding: Causes, Tips, And Exercises, 10 Helpful Ways To Increase Breastmilk Supply, Tummy Time For Babies: The Essential Guide To Get Your Baby Learning Early, Parenting An Adopted Child: Tips For A Smooth Transition, Diseases in which there is faulty formation of RBCs called. Increased red cell destruction is recognized by demonstrating increased quantities of the pigmentary products of their destruction, such as bilirubin and urobilinogen, in the blood plasma, urine, and feces and by evidence of accelerated erythropoiesis, such as an increase in the number of young cells (reticulocytes) in the blood. Pappenheimer Bodies: are intracellular inorganic iron-containing granules that may be ob-served on Wrights stained peripheral blood smears. The 2023 edition of ICD-10-CM R71.8 became effective on October 1, 2022. 3-5 polychromatc cells are found per microscopic feld c. more than fve polychromatc . The substitution of valyl for glutamyl in the sixth position of the -chain, for example, results in the formation of Hb S (the hemoglobin of sickle cell disease) instead of Hb A. This is attributable to a sex-linked, inherited deficiency of the enzyme G-6-PD. The disadvantage of such arbitrary criteria is that . }); Iron deficiency anemia signs and symptoms, Chest pain, fast heartbeat or shortness of breath, Unusual cravings for non-nutritive substances, such as ice, dirt or starch, Poor appetite, especially in infants and children with iron deficiency anemia, Dark green leafy vegetables, such as spinach, Dried fruit, such as raisins and apricots, Iron-fortified cereals, breads and pastas, Medications, such as oral contraceptives to lighten heavy menstrual flow, Antibiotics and other medications to treat peptic ulcers, Surgery to remove a bleeding polyp, a tumor or a fibroid, Hammadah M, Brennan ML, Wu Y, Hazen SL, Tang WH. Carbonyl iron (an iron supplement usually prescribed for the deficiency of iron ), Cyanocobalamin (vitamin b12) for treatment, Darbepoetin alfa (erythropoiesis stimulating agent prescribed for anemia). Heavy periods in women and gastric bleeding due to ulcers can also cause hypochromic anemia. Polychromasia is a lab finding that is seen in various conditions. You can usually correct iron deficiency anemia with iron supplementation. Common causes of iron deficiency are excessive menstrual loss in women and bleeding peptic ulcer in men. A peripheral blood film is a diagnostic tool that can be used to diagnose and monitor diseases that affect blood cells. All rights reserved. enable_page_level_ads: true Abnormalities in the globin chains can lead to disease. You can enhance your bodys absorption of iron by drinking citrus juice or eating other foods rich in vitamin C at the same time that you eat high-iron foods. Red blood cells constitutes major part of your blood volume. DIC (Disseminated intravascular coagulation), Klebsiella characteristics on MacConkey Agar, Clinical Case Leukocyte Vacoulation Bacterial Infection, Segmented neutrophilic granulocyte during degradation, Creatinine Phosphate Kinase (CPK) and CK-MB Overview. Removal of the spleen, which always is enlarged, cures the anemia by eliminating the site of sequestration and destruction of the red blood cells but does not prevent hereditary transmission of the disease. Pneumobilia Pain - Symptoms, Causes, Treatment, Ul Blepharochalasis - Pictures, Meaning, Symptoms, Ca Hypergonadism - Pictures, Symptoms, Causes, Treatment, Retrognathia - Pictures, Symptoms, Causes, Treatment, Pseudoparkinsonism - Symptoms, Causes, Treatment, Hypermetabolism - Symptoms, Causes, Treatment, Iron deficiency anemia (due to iron deficiency on red blood cells), Sideroblastic anemia (it can be inherited due to gene mutation or can be acquired. While a potential sign of a "stressed" marrow, it would be an over call to say this in . Changes in Red cells: These are various changes in the size and shape of your Red blood cells (RBCs). Lead poisoning is another leading cause of hypochromic anemia. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. All rights reserved to Healthcaretip.com | Powered by Blogger. Iron deficiency anemia develops when the diet lacks iron, the gastrointestinal tract fails to absorb dietary iron, or the amount of iron lost by the body is abnormally high 2. There are literally hundreds of possible causes of anemia: acute . There are no symptoms directly associated with polychromasia. These measurements were more sensitive than the conventional red cell indices for detecting blood donors with a low transferrin saturation. Normal red blood cell cytoplasm typically does not contain any debris, granules, or structures. Red blood cell morphology showed striking (3+) anisocytosis, polychromasia, and basophilic stippling (Figures 4, 5), as well as moderate (2+) hypochromia, microcytosis, and poikilocytosis, and mild (1+) target cells and fragments (Figure 6). Iron deficiency anemia is a common type of anemia a condition in which blood lacks adequate healthy red blood cells. Cells staining shades of blue, 'blue polychromasia', are unusually young reticulocytes. Your doctor will also treat the underlying cause of your iron deficiency, if necessary. The most common causes are Thalassemia and iron deficiency. Destruction of red cells at a rate substantially greater than normal, if not compensated for by accelerated red cell production, causes hemolytic anemia. Published Date: 11/01/2008;http://imagebank.hematology.org/getimagebyid/3787?size=3. These cigar-shaped erythrocytesare seen in the following conditions: Sickle Cell Anemia, if spleen removed due to, Overhydration (too much water, edema, too much IV fluid), Myelophthisic anemia-a severe anemia that is seen with some diseases affecting the bone marrow, such as granulomas, tumors, Myelofibrosis-seen with myeloproliferative disorders, such as leukemia, lymphoma, myeloma, metastatic carcinoma, Hemoglobin SC (RBCs may look like they have 1-2 "finger-like" projections, Schistocytes/Helmet Cells: Fragmented RBCs.