(3) Basophilic stippling. Round, small, blue-purple granules of varying size
in the cytoplasm of the red cell represent a condensation of the immature basophilic
substance (see poly-chromatophilia) that normally disappears with maturity. This is
known as basophilic stippling. It can be demonstrated by standard staining techniques
in contrast to reticulocyte filaments that require a special stain. Stippling occurs in
anemias and heavy metal poisoning (lead, zinc, silver, mercury, bismuth) and denotes
immaturity of the cell.
Figure 4-2j. Variations in erythrocytes:
a. Basophilic Stippled Erythrocyte.
(4) Heinz-Ehrlich bodies. These are small inclusions found primarily in
those hemolytic anemias induced by toxins. They are round, refractile bodies inside the
erythrocyte and are visible only in unfixed smears. It is thought that they are proteins
that have been dematured and that they are an indication of erythrocyte injury.
(5) Siderocytes. These are erythrocytes containing iron deposits. These
deposits indicate an incomplete reduction of the iron from ferric to the ferrous state that
is normally found in hemoglobin. Prussian blue stain must be used to readily
demonstrate these cells.
Figure 4-2k. Variations in erythrocytes:
a. Rubricytes (Pernicious Anemia).
Figure 4-2l. Variations in erythrocytes:
a. Metarubricyte (Pernicious Anemia)