Rouleaux
Peripheral blood smear, Wright-Giemsa stain, 1000x
Description:
Red cells are stacked in chains of varying lengths, and must be distinguished from hemagglutination which are aggregates of red cells.
Pathobiology:
Due to hyperproteinemia of whatever cause, more often with higher molecular weight proteins.
Differential diagnosis:
- Monoclonal gammopathies
- Waldenstrom's macroglobulinemia
- Multiple myeloma
- Monoclonal gammopathy of undetermined significance (MGUS)
- Polyclonal gammopathies
- Chronic inflammation, e.g. rheumatoid arthritis
- Other disorders, e.g. Castleman's disease
- Hyperfibrinogenemia
- Pregnancy
- Chronic inflammation
- α-2 macroglobulinemia- chronic inflammation
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Charles
E.
Hess,
M.D.,FACP [more information]
Professor of Internal Medicine
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