What does the shape of a cell mean?

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Question from Karen:
What does the shape of cells tell you? I recently had blood work return that showed a "1plus tear drop shape RBC," "1plus shistocytes," "large platelets" and "few atypical lymphocytes."

Answer from Dr. Leclair:
The shape of red cells reflects either an intrinsic damage to the cell as it was developing or the environment in which it was developing. Teardrop cells are typically seen in situations in which the bone marrow space is altered by some situation (for example, inflammation) or condition (for example, malignant cells present). 

Schistocytes are broken red cells. This typically happens when there is some form of damage to the walls of the blood vessels and, as the red cells move along inside the vessels, they "bounce up" against the wall and are torn. They attempt to reseal causing the change in shape. 

Large platelets happen when:

1) There is such a demand for platelets in the peripheral blood that they are released into the blood earlier then they should be; or,

2) The cells that make the platelets (megakaryocytes) are working in a difficult environment and are unable to control platelet quality.

The term "atypical" was first coined in the 1920 by a physician called Downey. He thought that these cells were the cause of a specific condition he was investigating. In the 1960s, it turned out that he was totally incorrect. These cells are lymphocytes that are actually fighting off disease—which is the exact opposite of being the disease. Since then, the correct term for these cells is "reactive" since that more correctly reflects what they do. Having a few could man that you were exposed to a cold virus or have a mild viral infection or were exposed to (and successfully fought off) any number of bacteria. These cells could also be seen if a serious condition (for example, some malignancy) has a strong antigenic component and the cells are trying to react to that.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Have a question for the experts? Send them to questions@patientpower.info.

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Page last updated on April 25, 2019