Rouleaux

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
Professor of Internal Medicine
Department of Medicine
Division of Hematology/Oncology

  M.D. Degree: University of Virginia, 1959
  Residency: Internal Medicine, University of Virginia
  Fellowship: Hematology, University of Virginia
  Certification: Internal Medicine
Hematology
  Research Interests: Hematologic malignancies, splenomegaly
  Department Web Site: http://www.healthsystem.vir
ginia.edu/internet/internal/
  Phone: (434) 924-2572