Hemolytic anemia, myelodysplasia, and liver disease may each fit this peripheral blood picture. Each of these conditions can display peripheral blood macrocytosis. It is easy to observe the overall larger size of the red blood cells in this image compared to the normal lymphocyte also present.
When macrocytes are present, they should be examined for their shape (round vs. oval), the hemoglobin content (central pallor), and whether or not there are any inclusions present in the cell.
Iron deficiency would not be the correct answer in this case, since this condition is associated with microcytosis instead.
The complete blood count was obtained from a patient recently admitted to the emergency room. The red blood cell indices obtained revealed an MCV of 115 femtoliters (fL) (normal range 80 – 90 fL). The patient met the criteria for a peripheral blood smear examination. A representative field is shown on the right.
Which of the following conditions may be indicated by the results seen on this peripheral blood smear?
A . Hemolytic anemia
B. Myelodysplasia
C. Iron deficiency
D. Liver disease
Answer: A,B,D
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