Howell-Jolly body

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 because a healthy spleen would normally filter this type of red blood cell.

It is named after William Henry Howell and Justin Marie Jolly.

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.

Howell–Jolly bodies are seen with markedly decreased splenic function. Common causes include asplenia (post-splenectomy) or congenital absence of spleen (Heterotaxy Syndrome with asplenia). Spleens are also 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, and myelodysplastic syndrome (MDS). The bodies can also can be seen in premature infants.

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