3.8: Pappenheimer Bodies (Siderotic Granules)

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: An iron stained peripheral blood smear with pappenheimer bodies present (indicated with arrows). Perls Prussian Blue. 50x oil immersion. From MLS Collection, University of Alberta, https://doi.org/10.7939/R3FN1173T

: An iron stained peripheral blood smear with pappenheimer bodies present (indicated with arrows). Perls Prussian Blue. 50x oil immersion. From MLS Collection, University of Alberta, https://doi.org/10.7939/R36689100

: A peripheral blood smear with pappenheimer bodies present (indicated with arrows). 100x oil immersion. From MLS Collection, University of Alberta, https://doi.org/10.7939/R35X25V0R

: A peripheral blood smear with pappenheimer bodies present (indicated with arrows). 100x oil immersion. From MLS Collection, University of Alberta, https://doi.org/10.7939/R3251G16Q

Appearance:

Inclusions are visible under both Wright/Romanowsky stains and Perls Prussian Blue stain. Pappenheimer inclusions appear as clusters of fine and irregular granules located at the periphery of the red blood cell.^1-3

Inclusion composition:³

Iron

Associated Disease/Clinical States:^1,2

Splenectomy

Sideroblastic Anemia

Thalassemia

Sickle Cell Disease

Hemachromatosis

References:

1. Landis-Piwowar K, Landis J, Keila P. The complete blood count and peripheral blood smear evaluation. In: Clinical laboratory hematology. 3rd ed. New Jersey: Pearson; 2015. p. 154-77.

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. Rodak BF, Carr JH. Inclusions in erythrocytes. In: Clinical hematology atlas. 5th ed. St. Louis, Missouri: Elsevier Inc.; 2017. p. 107-14.