This is the same blood as in the previous smear but it is stained for iron, giving the cells a blurred appearance. The iron is in the form of ferritin or hemosiderin. Red cells that have iron-containing, bluish-green granules are called siderocytes. Siderocytes are seen in anemias with disordered hemoglobin synthesis, which include sideroblastic anemias, thalassemia, refractory anemia, dyserythropoiesis, leukemia, and preleukemia. They are particularly evident in any of these diseases after splenectomy. The cause for the siderocytes in this patient was unclear. She was a 36-year-old chronic alcoholic with liver disease and pneumonia, and had not been splenectomized.
Course Section: 02. Inclusions Found in Red Blood Cells
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