Blister cell
(Pyknocyte, Hemighost)
Peripheral blood smear, Wright-Giemsa stain, 1000x
Description:
A red cell in which the hemoglobin is concentrated in one half of the cell with the other half mostly empty of hemoglobin giving a blister appearance.
Pathobiology:
Represents one of many red cell shapes that occur as a result of irregular contraction of red cells due either to damage to the membrane or shape changes that occur as a result of the removal of red cell inclusions (e.g. Heinz bodies, unstable hemloglobins, thalassemias), mostly by the spleen. The blister forms as a result of fusion of the inner red cell membranes on the end that is mostly devoid of hemoglobin. When the blister ruptures or is removed by the spleen, the red cell shape changes to that of a keratocyte (horn cell).
Differential Diagnosis:
- Impact hemolysis (e.g. TTP, DIC)
- Oxidant damage (e.g. G-6PD deficiency)
- Hemoglobin C disease
- SC-disease
- Thalassemias
- Unstable hemoglobins
- Dyserythropoiesis
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Charles
E.
Hess,
M.D.,FACP [more information]
Professor of Internal Medicine
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