Pappenheimer Bodies / Siderotic Cells

Peripheral smear from a patient with a history of sickle cell anemia. The arrows indicate hypochromic erythrocytes containing clusters of small irregular granules around the periphery of the red blood cell. These granules, composed of ferric iron, are called siderotic granules and appear as dark-blue granules in Wright stain. To verify that the red cell inclusions contain iron, it is necessary to use an iron stain such as Prussian blue.

A Color Atlas and Instruction Manual of Peripheral Blood Cell Morphology

By Barbara H. O'Connor

Exams for Oct 11 PM will be moved to Oct 16 AM schedule changes is as follows: 2:00 pm to 7:30 am 4:00 pm to 9:30 am 6:00 pm to 11:30 am In case there will be suspension tomorrow (saturday), Oct. 12 exams will be on Monday, Oct. 14, 2013. Original schedule will be followed. Please disseminate. - KASAMA/SSC Execom

Pappenheimer bodies (siderotic granules) are small, irregular magenta inclusions seen along (he periphery of red cells. They usually appear in clusters, as if they have been gently placed on the red cell membrane. Their presence on a Wrights or a supravital stained peripheral smear is presumptive evidence for the presence of iron. However, the Prussian blue stain is the confirmatory test for determining the presence of these inclusions. These bodies/granules in RBCs are nonheme iron, resulting from an excess of available iron throughout the body. Even though Pappenheimer bodies and siderotic granules are the same inclusion, they are designated differently depending on the stain used. The inclusions are termed Pappenheimer bodies, when seen in a Wrightstained smear and siderotic granules when seen in Prussian blue or other kinds of iron stain. The explanation for the difference in terminology is that Romanowsky stains visualize Pappenheimer bodies by staining the protein matrix of the granule, whereas Prussian blue stain is responsible for staining the iron portion of the granule. Once the presence of siderotic granules has been confirmed by iron stains, the cells in which they are found are termed siderocytes. Siderocytes containing a nucleus are described as sideroblasts and are commonly seen in sideroblastic anemias. Sideroblasts exhibiting numerous siderotic granules

found within the mitochondria forming a ring around at least one-third of the nucleus, are labeled as pathologic ringed sideroblasts. Siderocytes are seen in any condition in which there is iron overloading such as hemochromatosis or hemosiderosis. They may also be seen in the hemoglobinopathies (e.g., sickle cell anemia and thalassemia) and in patients following splenectomy.