Lab Med Online.  2019 Jul;9(3):185-188. 10.3343/lmo.2019.9.3.185.

Unique Red Blood Cell Morphology Detected in a Patient with Myelodysplastic Syndrome by Three-dimensional Refractive Index Tomography

• Koo SE
• Jang S
• Park CJ
• Cho YU
• Park Y

• KMID: 2450846
• DOI: http://doi.org/10.3343/lmo.2019.9.3.185

Abstract

The three-dimensional (3-D) shape of erythrocytes is strongly associated with various diseases. However, conventional optical imaging approaches with Wright's staining only provide information on two-dimensional morphology. Here, we employed optical diffraction tomography (ODT), a label-free 3-D quantitative phase imaging technique, and observed uniquely shaped red blood cells (RBCs) in the peripheral blood of a patient diagnosed with myelodysplastic syndrome. Peripheral blood samples were collected when the patient visited our hospital for his two out-patient follow-ups in May 2018. The 3-D tomograms of randomly chosen RBCs were reconstructed using a commercial ODT setup. From the reconstructed 3-D RBCs, 37.5% and 32.8% of RBCs demonstrated cup-like shapes at the first and the second out-patient follow-up, respectively. Even though this is a single case report, the finding is novel and can be a potential dyserythropoietic feature found in peripheral blood.

Keyword

Red blood cells; 3-D morphology; Myelodysplastic syndrome

MeSH Terms

Erythrocytes*
Follow-Up Studies
Humans
Myelodysplastic Syndromes*
Optical Imaging
Outpatients
Refractometry*

Figure

• 

  Fig. 1. Erythrocytes in peripheral blood from the treated patient diagnosed with MDS with excess blasts-2. (A) Light microscopy (Wright stain, ×1,000). (B-D) Upper and side views of reconstructed 3-D RBC images using an ODT setup microscope, HT-1H (Tomocube Inc., Korea) and a commercial software (Tomostudio, Tomocube, Inc., Korea). (B) Some of the cup-shaped RBCs found in the patient's peripheral blood. (C) Some of the abnormal RBCs excluding the cup-shaped RBCs found in the patient's peripheral blood. (D) Some normal RBCs found in the patient's peripheral blood. Abbreviations: MDS, myelodysplastic syndrome; RBC, red blood cell.

Reference

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