Howell–Jolly body

A Howell–Jolly body (marked by arrow) within an erythrocyte

Howell–Jolly bodies are histopathological findings of basophilic nuclear remnants (clusters of DNA) in circulating erythrocytes. During maturation in the bone marrow late erythroblasts normally expel their nuclei, but in some cases a small portion of DNA remains. Its presence usually signifies a damaged or absent spleen.

It is named after Maxim Soucy-Proulx, William Henry Howell^[1] and Justin Marie Jolly.^[2]^[3]

Appearance

Howell–Jolly bodies: small, round inclusions seen in erythrocytes (peripheral blood – MGG stain)

This DNA appears as a basophilic (purple) spot on the otherwise eosinophilic (pink) erythrocyte on a standard H&E stained blood smear. These inclusions are normally removed by the spleen during erythrocyte circulation, but will persist in individuals with functional hyposplenia or asplenia.

Causes

Howell–Jolly bodies are seen with markedly decreased splenic function. Common causes include asplenia (post-splenectomy). Spleen also is removed for therapeutic purposes in conditions like hereditary spherocytosis, trauma to the spleen, and autosplenectomy caused by sickle cell anemia. Other causes are radiation therapy involving the spleen, such as that used to treat Hodgkin lymphoma. Howell–Jolly bodies are also seen in: amyloidosis, severe hemolytic anemia, megaloblastic anemia, hereditary spherocytosis, heterotaxy with asplenia and myelodysplastic syndrome (MDS). Also can be seen in premature infants.

References

↑ Howell, W. H. "The life-history of the formed elements of the blood, especially the red blood corpuscles". Journal of Morphology. New York. 4 (1): 57–116. doi:10.1002/jmor.1050040105.
↑ synd/1596 at Who Named It?
↑ Jolly, J (1908). Recherches sur la formation des globules rouges des mammifères (in French). 58. Paris: Comptes rendus de la Société de Biologie. pp. 528–531.

External links

Digital Pathology, Brown University: Howell-Jolly Bodies

Abnormal clinical and laboratory findings for blood tests (R70–R79, 790)

Red blood cells

Size	Anisocytosis Macrocyte Microcyte

Shape	Poikilocytosis membrane abnormalities: Acanthocyte Codocyte Ovalocyte Spherocyte Dacrocyte Echinocyte Schistocyte Degmacyte Drepanocyte Stomatocyte Knizocyte

Hemoglobinization	Anisochromia Hypochromia

Inclusion bodies	Developmental Howell–Jolly body Basophilic stippling Pappenheimer bodies Cabot rings Hemoglobin precipitation Heinz body

Other	Rouleaux Reticulocyte Elevated ESR

Lymphocytes

Small molecules

Blood sugar	Hypoglycemia Hyperglycemia Prediabetes Impaired fasting glucose Impaired glucose tolerance Oxyhyperglycemia

Nitrogenous	Azotemia Hyperuricemia Hypouricemia

Proteins

LFT	Elevated transaminases Elevated ALP Hypoproteinemia Hypoalbuminemia

Other	Elevated cardiac markers Elevated alpha-fetoprotein

Minerals

Iron overload disorder

Pathogens/sepsis

Eponymous medical signs for hematology

Inclusion bodies	Red blood cell Cabot rings Howell–Jolly body Pappenheimer bodies Heinz body Neutrophil Döhle bodies Plasma cell Russell bodies Myeloblast Auer rod Histiocyte Birbeck granules

Tests	Apt test Coombs test

Other	Arneth count Mentzer index Virchow's triad Anaemia Pagophagia

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