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Diagnostic Tests: Teardrop Cells
Overview — What the Peripheral Smear Shows
The smear demonstrates teardrop cells (also called dacrocytes). These red blood cells appear stretched into a teardrop shape, a sign that they were physically distorted during their passage out of a diseased bone marrow.
Diagnostic Significance — When This Is the Answer
When teardrop cells are shown or described in a question stem, the correct diagnostic answer is:
Infiltrative Bone Marrow Disease
The most classic and high-yield association is:
- Myelofibrosis (primary or secondary)
Additional supporting clues may include:
- Pancytopenia
- Massive splenomegaly
- Weight loss, fatigue, night sweats
- Leukoerythroblastic smear (nucleated RBCs + left-shifted myeloid cells)
Bone marrow biopsy in myelofibrosis will reveal reticulin or collagen fibrosis, often making aspiration difficult (“dry tap”).
The diagnosis is chosen after excluding other causes of massive splenomegaly, such as hairy cell leukemia.
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