A dacrocyte (teardrop cell) is most characteristically associated with which condition?

A dacrocyte (teardrop cell) is most characteristically associated with which condition?

• A. Sickle cell disease
• B. Hemolytic anemia
• C. Myelofibrosis
• D. Liver disease

Answer: (C)

Teardrop-shaped red blood cells reflect a process where the bone marrow is fibrotic and obstructed, causing RBCs to squeeze through and become elongated as they enter the peripheral blood. This distortion is most classic in myelofibrosis, where marrow fibrosis forces hematopoiesis to occur outside the marrow (extramedullary hematopoiesis), and a leukoerythroblastic picture often accompanies it. The chronic fibrotic environment and extramedullary activity distort developing and mature cells, producing dacrocytes. Sickle cell disease centers on abnormally shaped, sickled cells due to hemoglobin polymerization, not tear drops. Hemolytic anemia shows increased reticulocytes and various RBC shapes from destruction but not specifically tear-drop forms. Liver disease can alter RBC morphology as well, but teardrop cells are not their hallmark.

Teardrop-shaped red blood cells reflect a process where the bone marrow is fibrotic and obstructed, causing RBCs to squeeze through and become elongated as they enter the peripheral blood. This distortion is most classic in myelofibrosis, where marrow fibrosis forces hematopoiesis to occur outside the marrow (extramedullary hematopoiesis), and a leukoerythroblastic picture often accompanies it. The chronic fibrotic environment and extramedullary activity distort developing and mature cells, producing dacrocytes.

Sickle cell disease centers on abnormally shaped, sickled cells due to hemoglobin polymerization, not tear drops. Hemolytic anemia shows increased reticulocytes and various RBC shapes from destruction but not specifically tear-drop forms. Liver disease can alter RBC morphology as well, but teardrop cells are not their hallmark.