A 40-year-old male had undergone splenectomy 20 years ago. Peripheral blood smear examination would show the presence of –
**Core Concept**
The presence of Howell-Jolly bodies in a peripheral blood smear is indicative of asplenia or hyposplenism. This is because the spleen plays a crucial role in filtering out old or damaged red blood cells, including those containing Howell-Jolly bodies, which are residual nuclear material.
**Why the Correct Answer is Right**
In an individual with asplenia or hyposplenism, such as our patient who has undergone splenectomy, the absence of a functioning spleen leads to the accumulation of Howell-Jolly bodies in the red blood cells. These bodies are small, round inclusions that represent residual nuclear material within the red blood cell. Normally, the spleen would filter out these inclusions, but in the absence of the spleen, they persist and can be visualized on a peripheral blood smear.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not relate to the presence of Howell-Jolly bodies.
**Option B:** This option is incorrect because it describes a different type of inclusion body, known as a siderocyte, which is associated with iron overload.
**Option C:** This option is incorrect because it describes a different type of abnormality, known as a spherocyte, which is associated with hereditary spherocytosis.
**Clinical Pearl / High-Yield Fact**
In patients with asplenia or hyposplenism, the presence of Howell-Jolly bodies on a peripheral blood smear can be a useful diagnostic clue, particularly in the context of a history of splenectomy or other conditions that may affect spleen function.
**Correct Answer:** C. Sickle-shaped red blood cells are not typically associated with splenectomy.