Pencil cells - Revision history

John at 09:01, 27 March 2023

2023-03-27T09:01:56Z

← Older revision		Revision as of 11:01, 27 March 2023
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	<span style="font-style:italic; font-size:90%;'' >		<span style="font-style:italic; font-size:90%;'' >
	'''Image 1: ''' Note the considerable elongation of the pencil form with a length at least four times that of its width and generally ~~a little~~ more "blunt-ended" than a elliptocyte. The cell is also hypochromic with pale colour and extensive central pallor. Generally, this erythrocyte form arises in the context of iron deficiency so will be accompanied by hyposchromic and microcytic cells.		'''Image 1: ''' Note the considerable elongation of the pencil form with a length at least four times that of its width and generally more "blunt-ended" than an elliptocyte. The cell is also hypochromic with pale colour and extensive central pallor. Generally, this erythrocyte form arises in the context of iron deficiency so will be accompanied by hyposchromic and microcytic cells.
	</span>		</span>

John at 09:01, 27 March 2023

2023-03-27T09:01:05Z

← Older revision		Revision as of 11:01, 27 March 2023
Line 15:		Line 15:

	<span style="font-style:italic; font-size:90%;'' >		<span style="font-style:italic; font-size:90%;'' >
	'''Image 1: ''' Note the considerable elongation of the pencil form with a length at least four times that of its width. The cell is also hypochromic with pale colour and extensive central pallor. Generally, this erythrocyte form arises in the context of iron deficiency so will be accompanied by hyposchromic and microcytic cells.		'''Image 1: ''' Note the considerable elongation of the pencil form with a length at least four times that of its width and generally a little more "blunt-ended" than a elliptocyte. The cell is also hypochromic with pale colour and extensive central pallor. Generally, this erythrocyte form arises in the context of iron deficiency so will be accompanied by hyposchromic and microcytic cells.
	</span>		</span>

John at 09:00, 27 March 2023

2023-03-27T09:00:01Z

← Older revision		Revision as of 11:00, 27 March 2023
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	<gallery mode="nolines" widths="240px" heights="240px" border="1px" >		<gallery mode="nolines" widths="240px" heights="240px" border="1px" >
	File:~~Pen1~~.png\|link={{filepath:~~Pen1~~.png}}		File:Pen1A.png\|link={{filepath:Pen1A.png}}
	File:Pen2.jpg\|link={{filepath:Pen2.jpg}}		File:Pen2.jpg\|link={{filepath:Pen2.jpg}}
	</gallery>		</gallery>

John at 11:58, 22 March 2023

2023-03-22T11:58:01Z

← Older revision		Revision as of 13:58, 22 March 2023
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			<gallery widths="250px" heights="250px" >
			File:Pen4.jpg\|link={{filepath:Pen4.jpg}}
			</gallery>

	~~<span style="font-size:90%"><span style="color:#808080">~~
	~~'''''Clinical Image 1:''' . t''~~

	<span style="font-size:90%~~"><span style="color:#808080"~~>		<span style="font-style:italic; font-size:90%;'' >
	'''''Clinical Image 2:''' This image contains very hypochromic erythrocytes with central pallor extending more than 50% of the cell area, they are also small (compare with the nucleus of the single erythrocyte). Two examples should be regarded as pencil cells; a further cell is significantly elliptocytic.''		'''''Clinical Image 1: 'This image contains very hypochromic erythrocytes with central pallor extending more than 50% of the cell area, they are also small (compare with the nucleus of the single erythrocyte). Two examples should be regarded as pencil cells; a further cell is significantly elliptocytic.''


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John at 11:56, 22 March 2023

2023-03-22T11:56:37Z

← Older revision		Revision as of 13:56, 22 March 2023
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	Clinical Examples		'''Clinical Examples'''


	~~<span style="font-size:90%"><span style="color:#808080">~~
	<gallery widths="250px" heights="250px" >		<gallery widths="250px" heights="250px" >
	File:Pen3.jpg\|~~''1.Clinical Image 1''~~		File:Pen3.jpg\|link={{filepath:Pen3.jpg}}
	~~File~~:~~Pen4~~.jpg~~\|left\|text-center\|200px\|Clinical Image 2~~
	</gallery>		</gallery>


			<span style="font-style:italic; font-size:90%;'' >
			'''''Clinical Image 1: '''A single and well-formed pencil cell, note the greatly elongated form with a length that greatly exceeds the length. The remaining cells are clearly hypochromic with an expanded area of central pallor.
			</span>




	<span style="font-size:90%"><span style="color:#808080">		<span style="font-size:90%"><span style="color:#808080">
	'''''Clinical Image 1:''' ~~A single and well-formed pencil cell, note the greatly elongated form with a length that greatly exceeds the length. The remaining cells are clearly hypochromic with an expanded area of central pallor~~. t''		'''''Clinical Image 1:''' . t''

	<span style="font-size:90%"><span style="color:#808080">		<span style="font-size:90%"><span style="color:#808080">

John at 11:54, 22 March 2023

2023-03-22T11:54:52Z

← Older revision		Revision as of 13:54, 22 March 2023
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	\|In many disorders with defective red cell formation occasional very elongated cells may be seen, but the term is probably best restricted to hypochromic red cell forms		\|In many disorders with defective red cell formation occasional very elongated cells may be seen, but the term is probably best restricted to hypochromic red cell forms
	\|}		\|}
			</div>


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John at 11:54, 22 March 2023

2023-03-22T11:54:25Z

← Older revision		Revision as of 13:54, 22 March 2023
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	'''Significance'''		'''Significance'''
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	'''Causes'''		'''Causes'''

	{\| class="wikitable" style="color:~~navy~~; background-color:#ffffff;" cellpadding="15"		<div style="width: 95%; overflow: auto; border: 1px solid navy; font-size:100%">
			{\| class="wikitable" style="color:black; background-color:#ffffff;" cellpadding="15"
	!colspan="1"\|'''Expected finding'''		!colspan="1"\|'''Expected finding'''
	\|-		\|-

John at 11:53, 22 March 2023

2023-03-22T11:53:45Z

← Older revision		Revision as of 13:53, 22 March 2023
Line 15:		Line 15:

	<span style="font-style:italic; font-size:90%;'' >		<span style="font-style:italic; font-size:90%;'' >
	'''''Image 1: ''' Note the considerable elongation with a length at least four times that of its width. The cell is also hypochromic with pale colour and extensive central pallor''		'''Image 1: ''' Note the considerable elongation of the pencil form with a length at least four times that of its width. The cell is also hypochromic with pale colour and extensive central pallor. Generally, this erythrocyte form arises in the context of iron deficiency so will be accompanied by hyposchromic and microcytic cells.
	~~</span>~~

	~~<span style="font-size:90%"><span style="color:#808080">~~
	~~'''''Image 2: '''~~Generally, this erythrocyte form arises in the context of iron deficiency so will be accompanied by hyposchromic and microcytic cells. ~~Be aware of the less common causes and if features do not fit consider alternative interpretations of the cell.''~~
	</span>		</span>

John at 11:52, 22 March 2023

2023-03-22T11:52:35Z

← Older revision		Revision as of 13:52, 22 March 2023
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	~~----~~

	'''Derivation:''' ''little tail''		'''Derivation:''' ''little tail''

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	<~~span style~~="~~font-size:90%~~"~~><span style~~="~~color:#808080~~">		<gallery mode="nolines" widths="240px" heights="240px" border="1px" >
	~~<gallery widths~~="~~180px~~" ~~heights~~="~~180px~~" >		File:Pen1.png\|link={{filepath:Pen1.png}}
	File:Pen1.png\|1: ~~Pencil cell~~		File:Pen2.jpg\|link={{filepath:Pen2.jpg}}
	File:Pen2.~~png~~\|~~200px\|Image 2~~: ~~Pencil cell context~~		</gallery>


	~~</gallery>~~		<span style="font-style:italic; font-size:90%;'' >
	<span style="font-size:90%~~"><span style="color:#808080"~~>
	'''''Image 1: ''' Note the considerable elongation with a length at least four times that of its width. The cell is also hypochromic with pale colour and extensive central pallor''		'''''Image 1: ''' Note the considerable elongation with a length at least four times that of its width. The cell is also hypochromic with pale colour and extensive central pallor''
	</span>		</span>

John: Created page with " ---- '''Derivation:''' ''little tail'' ---- '''Appearance''' Long thin cells (roughly speaking they have at length more than 4 times their width); pencil cells are generally hypochromic. The cells have blunt rounded ends and no curvature and should not be confused with sickle cells File:Pen1.png|1: Pencil cell File:Pen2.png|200px|Image 2: Pencil cell context
2023-02-19T17:41:19Z

Created page with " ---- '''Derivation:''' ''little tail'' ---- '''Appearance''' Long thin cells (roughly speaking they have at length more than 4 times their width); pencil cells are generally hypochromic. The cells have blunt rounded ends and no curvature and should not be confused with sickle cells <gallery widths="180px" heights="180px" > File:Pen1.png|1: Pencil cell File:Pen2.png|200px|Image 2: Pencil cell context </gall..."

New page

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'''Derivation:''' ''little tail''

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'''Appearance'''

Long thin cells (roughly speaking they have at length more than 4 times their width); pencil cells are generally hypochromic. The cells have blunt rounded ends and no curvature and should not be confused with sickle cells


<gallery widths="180px" heights="180px" >
File:Pen1.png|1: Pencil cell
File:Pen2.png|200px|Image 2: Pencil cell context

</gallery>

'''''Image 1: ''' Note the considerable elongation with a length at least four times that of its width. The cell is also hypochromic with pale colour and extensive central pallor''



'''''Image 2: '''Generally, this erythrocyte form arises in the context of iron deficiency so will be accompanied by hyposchromic and microcytic cells. Be aware of the less common causes and if features do not fit consider alternative interpretations of the cell.''


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'''Significance'''

These cells may be considered as variants of elliptocytes; however, the term “pencil cell” is generally applied to the hypochromic forms associated with iron deficiency. The pencil cell is often used to discriminate between iron deficiency and thalassaemia; however, the distinction is not absolute and pencil cells may occur in thalassaemia or anaemia of chronic disease (although less frequently).

'''Pathobiology'''

Pencil cells most frequently arise in the context of iron deficiency rather than elliptocytic disorders, however the precise mechanism for their formation is unclear.

'''Pitfalls'''

The cellular context is very important here – pencil cells should be hypochromic and be accompanied by hypochromic cells. Cells with greatly elongated form may arise in other conditions where there is very abnormal red cell morphology (e.g. a severe elliptocytosis or myelodysplasia), but these should not be described as pencil cells.

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'''Causes'''

{| class="wikitable" style="color:navy; background-color:#ffffff;" cellpadding="15"
!colspan="1"|'''Expected finding'''
|-
|Iron deficiency – increasing likely to be seen in more severe cases
|-
!colspan="1"|'''May occur in'''
|-
||Thalassaemia (although much less common)
|-
|Anaemia of chronic disease (relatively uncommon)
|-
!colspan="1"|'''As part of a specrum of features'''
|-
|In many disorders with defective red cell formation occasional very elongated cells may be seen, but the term is probably best restricted to hypochromic red cell forms
|}

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Clinical Examples


<gallery widths="250px" heights="250px" >
File:Pen3.jpg|''1.Clinical Image 1''
File:Pen4.jpg|left|text-center|200px|Clinical Image 2
</gallery>


'''''Clinical Image 1:''' A single and well-formed pencil cell, note the greatly elongated form with a length that greatly exceeds the length. The remaining cells are clearly hypochromic with an expanded area of central pallor. t''


'''''Clinical Image 2:''' This image contains very hypochromic erythrocytes with central pallor extending more than 50% of the cell area, they are also small (compare with the nucleus of the single erythrocyte). Two examples should be regarded as pencil cells; a further cell is significantly elliptocytic.''

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