Representative peripheral blood and bone marrow smears from a patient with X-linked sideroblastic anemia. (A) Peripheral blood smear showing many hypochromic and microcytic cells. May-Grünwald-Giemsa (MGG), x1,000. (B) Bone marrow smear showing erythroid hyper plasia: erythroblasts are small with abnormal condensation of nuclear chromatin and ragged cytoplasm with ill-defined edges. MGG, x1,000. (C) Bone marrow smear showing erythroblasts with defective hemoglobinization (left) and erythroblasts containing multiple Pappenheimer bodies (right). MGG, x1,250. (D) Bone marrow smear. Perls’ stain shows that most erythroid precursors are ring sideroblasts with at least five positive granules disposed in a ring surrounding a third or more of the circumference of the nucleus. x1,250. | Cazzola, M., & Invernizzi, R. (2011). Ring sideroblasts and sideroblastic anemias. Haematologica, 96(6), 789 LP – 792. https://doi.org/10.3324/haematol.2011.044628

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