Howell-Jolly bodies

Howell-Jolly body

How the ‘Howell-Jolly bodies’ is produced?

In the bone marrow, late erythroblasts normally expel their nuclei; but, in some cases, a small portion of DNA remains which appears as Howell-Jolly bodies.

What is the clinical significance of presence of ‘Howell-Jolly bodies’ in peripheral smear?

Normally a healthy spleen removes red blood cells with ‘Howell-Jolly bodies’.

Presence of ‘Howell-Jolly bodies’ in peripheral smear suggests damaged or absent spleen,

Most common cause of ‘Howell-Jolly bodies?

‘Howell-Jolly bodies’ – Most commonly present in patients with absent or impaired function of the spleen

What are the causes of ‘Howell-Jolly bodies’?

Howell-Jolly bodies – pathognomonic for splenic dysfunction, but can be found in other disorders: 

  1. post-splenectomy,
  2. sepsis,
  3. congenital disorders,
  4. sickle cell hemoglobinopathies,
  5. alcoholism,
  6. lupus and other autoimmune disorders,
  7. post-bone marrow transplantation. 

Howell-Jolly bodies

Target cells (codocytes)

Bullseyes appearance of Cells

Target cells (codocytes) appear as bullseyes, seen in

  1. liver disease,
  2. alpha/beta thalassemia,
  3. hemoglobin C disease
  4. asplenia


Spherocytes, noted by the lack of a pale center can been seen most commonly in

  • hemolytic anemia
  • hereditary spherocytosis)

Schistocytes & helmet cells

Schistocytes (red arrow) and helmet cells (blue arrow) are common in –

Mechanism – shearing or mechanical destruction of the red cells. –
Diseases –

  1. disseminated intravascular coagulation
  2. thrombotic thrombocytopenic purpura
    3, aortic stenosis.

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