Note - the spherocytes and the polychromatophilia with the nucleated rbc

The stomatocyte that we see here are normal.

Stomatocyte Description:

Instead of having the rounded central palor of a normal red cell, a stomatocyte has a centrally located linear slit or stoma (fish mouth) and the MCV is usually increased. On scanning EM, a stomatocyte looks like a ball with a single concavity (cup-shaped).

Pathobiology:

Unlike the echinocyte, stomatocyte formation is due to expansion of the inner leaflet of the lipid bilayer.

Differential diagnosis:

Normal blood smear (low percentage)

Alcohol excess- MCV increased in absence of anemia

Liver disease- macrotarget cells and acanthocytes may also be present

Hereditary stomatocytosis

Some subtypes of hereditary spherocytosis