University of Virginia Health System

Horn cell
(Keratocyte)

Peripheral blood smear, Wright-Giemsa stain, 1000x

Description:

An irregularly contracted red cell that has one or more rounded projections and lacks central palor. The most frequent form has two projections (helmet cell). May also see ghost or hemighost (blister) cells.

Pathobiology:

Occurs as a result of the formation of pseudovacuoles near the edge of the red cell membrane that subsequently rupture, or are removed by the spleen. Also may occur as a result of removal of an inclusion (e.g. Heinz body) by the spleen (pitting function).

Differential diagnosis:

• Impact hemolysis and Heinz body hemolytic anemias
• Dyserythropoiesis- the range of poikilocytosis seen in the various dyserythropoietic disorders is quite broad.

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