A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
Red corpuscles which vary from the normal in size and shape are
present in most symptomatic anemias, and in the severer grades are
often very numerous. Irregularities are particularly conspicuous in
leukemia and pernicious anemia, where, in some instances, a normal
erythrocyte {176} is the exception. In pernicious anemia there is a
decided tendency to large size and oval forms, and megalocytes are
rarely found in any other condition.
(2) Variations in Staining Properties (See Plate VIII).--These include
polychromatophilia, basophilic degeneration, and basophilic stippling.
They are probably degenerative changes, although polychromatophilia is
thought by many to be evidence of youth in a cell, and hence to
indicate an attempt at blood regeneration.
(_a_) _Polychromatophilia_.--Some of the corpuscles partially lose
their normal affinity for acid stains, and take the basic stain to
greater or less degree. Wright's stain gives such cells a faint bluish
tinge when the condition is mild, and a rather deep blue when severe.
Sometimes only part of a cell is affected. A few polychromatophilic
corpuscles can be found in marked symptomatic anemias. They occur most
abundantly in malaria, leukemia, and pernicious anemia.
(_b_) _Basophilic Granular Degeneration_ (_Degeneration of
Grawitz_).--This is characterized by the presence, within the
corpuscle, of small basophilic granules. They stain deep blue with
Wright's stain; not at all, with Ehrlich's triple stain. The cell
containing them may stain normally in other respects, or it may
exhibit polychromatophilia.
Numerous cells showing this degeneration are commonly found in chronic
lead-poisoning, of which they were at one time thought to be
pathognomonic. Except in this disease, the degeneration indicates a
serious blood condition. It occurs in well-marked cases of pernicious
anemia and leukemia, and, much less commonly, in very severe
symptomatic anemias.
(_c_) _Basophilic Stippling_.--This term has been applied {177} to the
finely granular appearance often seen in red corpuscles, which harbor
malarial parasites (Plate VI). It is commonly classed with the
degeneration just described, but is probably distinct. Not all stains
will show it. With Wright's stain it can be brought out by staining
longer and washing less than for the ordinary blood-stain. The minute
granules stain reddish purple.
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