Which RBC morphology is most associated with thalassemias?

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Multiple Choice

Which RBC morphology is most associated with thalassemias?

Target cells arise when red cells have an increased membrane surface area relative to their volume, a common consequence of the decreased hemoglobin content in thalassemias. The resulting microcytic, hypochromic cells display a bullseye appearance on the smear: a central area of pallor surrounded by a ring of hemoglobin and an outer border of membrane. This characteristic shape reflects the imbalanced globin synthesis and the cell’s attempt to maintain integrity with relatively more membrane. Other shapes reflect different processes: fragmented schistocytes come from mechanical destruction, elliptical cells from membrane defects such as hereditary elliptocytosis, and sickle-shaped cells from HbS polymerization in sickle cell disease. The target cell morphology is the one most classically associated with thalassemias.

Target cells arise when red cells have an increased membrane surface area relative to their volume, a common consequence of the decreased hemoglobin content in thalassemias. The resulting microcytic, hypochromic cells display a bullseye appearance on the smear: a central area of pallor surrounded by a ring of hemoglobin and an outer border of membrane. This characteristic shape reflects the imbalanced globin synthesis and the cell’s attempt to maintain integrity with relatively more membrane.

Other shapes reflect different processes: fragmented schistocytes come from mechanical destruction, elliptical cells from membrane defects such as hereditary elliptocytosis, and sickle-shaped cells from HbS polymerization in sickle cell disease. The target cell morphology is the one most classically associated with thalassemias.

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