Peripheral blood smears demonstrating marked poikilocytosis. From MLS Collection, University of Alberta.

Image 1: 50x oil immersion. https://doi.org/10.7939/R3KD1R163

Image 2: https://doi.org/10.7939/R3RV0DG2H

General Peripheral Blood Smear Description:

Poikilocytosis is a general term used to describe the collective presence of various abnormal red blood cell shapes on a peripheral blood smear. Normal red blood cell morphology is described in the previous two chapters but under certain clinical conditions, they can take on various shapes or morphologies. When certain red blood cell shapes are predominant, this may be associated with specific disease states.^1-3 

Associated Disease/Clinical States:^3-4

Hemolytic anemias

Thalassemia

Myelofibrosis

Hereditary pyropoikilocytosis

Note: See the rest of the chapter for other disease states related to a specific predominant abnormal morphology.

References:

1. Rodak BF, Carr JH. Variations in shape and distribution of erythrocytes. In: Clinical hematology atlas. 5th ed. St. Louis, Missouri: Elsevier Inc.; 2017. p. 93-106.

2. Jones KW. Evaluation of cell morphology and introduction to platelet and white blood cell morphology. In: Clinical hematology and fundamentals of hemostasis. 5th ed. Philadelphia: F.A. Davis Company; 2009. p. 93-116.

3. Turgeon ML. Erythrocyte morphology and inclusions. In: Clinical hematology: theory and procedures. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 1999. p. 99-111.

4. Coetzer TL, Zail S. Introduction to hemolytic anemias: intracorpusculardefects: I. hereditary defects of the red cell membrane.  In: Clinical hematology and fundamentals of hemostasis. 5th ed. Philadelphia: F.A. Davis Company; 2009. p. 176-95.