Primary Hematopoietic and Lymphoid Tissue ›› Bone Marrow ›› Abnormal

Dysplastic Nucleated RBC*


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› Microscopic Features:

• Size is variable depending on the stage of maturation
• nuclear to cytoplasmic dyssynchrony may be seen
• Nucleus may have irregularities such as blebbing, binucleation with bridging and multinucleation
• Cytoplasm may contain vacuoles, chromatin remnants (Howell-Jolly bodies), or RNA remnants (basophilic stippling)

› Normal % blood-PB, marrow-BM, lymphoid tissue-LN:

• PB: None
• BM: None
• LN: None

› May Resemble:

• Polychromatophilic normoblasts [Compare]
• Orthochromic normoblast [Compare]
• Lymphocyte (mature) [Compare]
• RBC with Howell Jolly Body [Compare]

› Differential Diagnoses:

Myelodysplastic Syndrome Acute Myeloid Leukemia Toxin-induced Chemotherapy-induced Congenital dyserythropoietic anemia

› Classic Immunophenotype:

• CD45-
• CD117-
• CD235a (Glycophorin A) dim+
• CD71+
• Note: The immunoprofile can be variable and may show aberrancies

› Cartoon Image:


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› Misc:

• Note: Some morphologic features are stronger evidence of dysplasia than others. Nuclear blebbing, "binucleation with bridging" and multinucleation are usually considered as dysplastic features. However, the findings must always be interpreted in the correct context.