Blood/Blood Cells and Cellular Components ›› Red Blood Cells ›› Abnormal Pappenheimer Bodies* Click Here for Full Size › Microscopic Features: Irregular, small blue-purple granule aggregates in RBCs The granules are usually located at the periphery of the RBC › Normal % blood-PB, marrow-BM, lymphoid tissue-LN: PB: None BM: None LN: None › May Resemble: Howell-Jolly body (iron stain negative) Basophilic stippling (iron stain negative) Heinz body (iron stain negative, visible only after supravital stain) Hemoglobin H inclusions (iron stain negative, visible only after supravital stain) Malaria infection Babesia infection Fungal infection Artifacts (e.g. Stain precipitate) › Differential Diagnoses: Thalassemia Sideroblastic anemia Hemolytic anemia Post-splenenctomy › Classic Immunophenotype: N/A › Cartoon Image: Click and drag for direct comparison › Misc: Note: Basophilic stippling is due to ribosomal inclusions in RBCs, while papenheimer bodies are iron deposits, Heinz bodies are precipitated hemoglobin seen with special stain (He for Heinz and He for Hemoglobin), and Howell Jolly bodies are DNA remnants The aggregates are partially composed of Iron but visible with and without iron stain (as opposed to sideroblast's iron granules which are only visible with iron stain)