Peripheral smear findings in beta-thalassemia commonly include which finding?

• A. Target cells
• B. Teardrop cells
• C. Spherocytes
• D. Howell-Jolly bodies

Answer: (A)

The main idea here is that beta-thalassemia commonly causes target cells on a peripheral smear. In beta-thalassemia, there is imbalanced globin chain production leading to a microcytic, hypochromic anemia with excess membrane relative to the reduced hemoglobin content. This increased surface-area-to-volume ratio creates the characteristic target cell appearance: a dark center, a pale halo, then a dark outer ring. You’ll often also see marked microcytosis, hypochromia, and sometimes nucleated red cells due to marrow expansion.

Why the other options fit poorly: teardrop cells arise from marrow infiltration or displacement (as in myelofibrosis) or severe reticulocytosis, not specifically beta-thalassemia. Spherocytes occur in hereditary spherocytosis or autoimmune hemolytic anemia, where cells become more spherical and less able to deform. Howell-Jolly bodies indicate asplenia or hyposplenism, reflecting splenic dysfunction rather than a globin-build issue.