Images show peripheral blood smears with numerous tear cells (examples indicated by arrows). From MLS Collection, University of Alberta.

Image 1: 50x oil immersion. https://doi.org/10.7939/R37S7J768

Image 2: https://doi.org/10.7939/R3D21S07J

Image 3: https://doi.org/10.7939/R38P5VR5R

Cell Description:

Red blood cells that are teardrop or pear shaped with one blunt projection.¹ The size of these cells are variable.²

Cell Formation:

Red blood cells with inclusions: Teardrop cells form from these cells when the cells attempt to pass through the microcirculation resulting in the pinching the cell as the part containing the inclusion is left behind.²

Myelophthisis: displacement of normal hematopoietic tissue in the bone marrow by abnormal cells (malignancies) or fibrosis, leading to bone marrow crowding and pinching of RBCs as they as pushed out of the bone marrow.

Associated Disease/Clinical States:^1-3

Primary myelofibrosis

Thalassemia

Megaloblastic Anemia

Sideroblastic Anemia

Myelophthisic Anemia

Drug-induced Heinz body formation

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, 289.

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. Bain BJ. Morphology of blood cells. In: Blood cells: a practical guide [Internet]. 5th ed. Chichester, UK: John Wiley & Sons, Ltd; 2015 [cited 2018 Jul 10]: 67-185. Available from: http://doi.wiley.com/10.1002/9781118817322