A patient with hereditary spherocytosis undergoes splenectomy. Post-operatively, peripheral smear shows Howell-Jolly bodies and target cells appear along with persistent spherocytes. The Howell-Jolly bodies represent:

• A Residual mitochondria not cleared during reticulocyte maturation
• B Denatured hemoglobin aggregates (Heinz bodies seen with vital stains)
• C Nuclear remnants (DNA fragments) normally removed by splenic macrophages ✓
• D Iron-containing organelles similar to sideroblastic inclusions

Explanation

Howell-Jolly bodies are nuclear remnants (small DNA fragments) that are normally removed from circulating erythrocytes by splenic macrophages via a process called pitting. After splenectomy, this clearance mechanism is lost and the nuclear remnants persist in circulating RBCs, appearing as small, dense, single purple dots on Romanowsky stain. Heinz bodies are denatured hemoglobin aggregates visible only with supravital stains. Their presence is a reliable marker of functional hyposplenism and post-splenectomy state.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.