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Blood film features:
- Macrocytosis
- Oval macrocytes
- Teardrop cells
- Anisopoikilocytosis can become marked in severe B12 deficiency, with RBC fragments and microcytes (dyserythropoietic features)
- Neutrophil hypersegmentation
- Eosinophils and basophils may also be hypersegmented
- No polychromasia
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Bone marrow aspirate from a patient with megaloblastic anaemia. Use the settings toolbar to adjust the brightness if the image appears too dark.
Bone marrow features:
- Nuclear-cytoplasmic asynchrony
- Increase in basophilic erythroblasts
- Reduction in myeloid:erythroid ratio
- Giant metamyelocytes and band forms
- Horseshoe-shaped nuclei in myeloid precursors
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