Clinical chemistry and laboratory medicine · 2026
Fish-shaped erythrocytes and pincer cells co-occur in distinct hematological disorders and are associated with anemia severity.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lembeck Anna Lena, Wölfler Albert, Zebisch Armin, Robier Christoph
Аннотация
OBJECTIVES: Red blood cell (RBC) morphology in peripheral blood smears (PBS) remains essential for the differential diagnosis of anemia and other hematologic disorders. As yet unclassified poikilocytes, fish-shaped RBCs and pincer (mushroom-shaped) cells are rarely observed but have been described as "bizarre erythrocytes" and linked to hereditary spherocytosis. This study aimed to investigate their relevance across a spectrum of hematologic diseases and provide a basis for future morphological standardization.
METHODS: Peripheral blood smears from 251 specimens were systematically reviewed, including cases of iron deficiency anemia (IDA), β-thalassemia minor (BTM), sickle cell disease (SCD), microangiopathic hemolytic anemia (MAHA), autoimmune hemolytic anemia (AIHA), hereditary spherocytosis (HS), hereditary elliptocytosis (HE), vitamin B12/folate deficiency, myelodysplastic neoplasms (MDS), primary myelofibrosis (PMF), malaria, liver disease (LD), and healthy controls. Abnormal RBC morphologies were quantified as cells per 20 high-power fields at 1,000 × magnification. Group comparisons used the Mann-Whitney U test and correlations were assessed by Spearman's rank correlation.
RESULTS: Numbers of fish-shaped and pincer cells were significantly increased in IDA, BTM, MDS, HE, PMF, and vitamin B12/folate deficiency with a strong positive intercorrelation (p<0.01) in most of these diseases. Pincer cells were also elevated in HS and hemoglobin levels were negatively correlated with both fish and pincer cells across all disorders studied (p<0.0001).
CONCLUSIONS: Fish-shaped RBCs and pincer cells represent abnormal erythrocyte morphologies associated with a range of hematologic disorders and correlate with severity of anemia. Their strong intercorrelation suggests a shared pathophysiologic mechanism or may reflect different stages of a common morphological process.
METHODS: Peripheral blood smears from 251 specimens were systematically reviewed, including cases of iron deficiency anemia (IDA), β-thalassemia minor (BTM), sickle cell disease (SCD), microangiopathic hemolytic anemia (MAHA), autoimmune hemolytic anemia (AIHA), hereditary spherocytosis (HS), hereditary elliptocytosis (HE), vitamin B12/folate deficiency, myelodysplastic neoplasms (MDS), primary myelofibrosis (PMF), malaria, liver disease (LD), and healthy controls. Abnormal RBC morphologies were quantified as cells per 20 high-power fields at 1,000 × magnification. Group comparisons used the Mann-Whitney U test and correlations were assessed by Spearman's rank correlation.
RESULTS: Numbers of fish-shaped and pincer cells were significantly increased in IDA, BTM, MDS, HE, PMF, and vitamin B12/folate deficiency with a strong positive intercorrelation (p<0.01) in most of these diseases. Pincer cells were also elevated in HS and hemoglobin levels were negatively correlated with both fish and pincer cells across all disorders studied (p<0.0001).
CONCLUSIONS: Fish-shaped RBCs and pincer cells represent abnormal erythrocyte morphologies associated with a range of hematologic disorders and correlate with severity of anemia. Their strong intercorrelation suggests a shared pathophysiologic mechanism or may reflect different stages of a common morphological process.