Effect of splenectomy on teardrop-shaped erythrocytes in agnogenic myeloid metaplasia

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Abstract
Teardrop-shaped erythrocytes (TD) are frequently observed in the peripheral blood of patients with agnogenic myeloid metaplasia (AMM). These deformed cells may result from the myelofibrosis or the extramedullary hematopoiesis in the spleen. To determine the influence of the spleen on TD formation, presplenectomy (pre-S) and postsplenectomy (post-S) peripheral blood smears were reviewed from 13 patients with AMM. The splenectomy was performed for a variety of reasons, including symptomatic hypersplenism or splenomegaly. The average number of TD per 1000 RBC in the pre-S smears was 42 (range, 15-112 TD), compared with 11 TD in the post-S smears (range, 6-20 TD) (P < .001). Only 1 of the 13 patients failed to exhibit this decrease in TD post-S. There was no definite correlation between the number of TD and the weight of the spleen removed at surgery, the interval since surgery, or age and sex of the patient. Based on this 4-fold decrease in the number of TD post-S, the spleen in AMM seems to play an important role in TD formation.

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