Rouleaux and Agglutination
- Red blood cells (RBCs) appear as "stacked coins."
- Cells overlap each other.
- Stacked-coin morphology is noted throughout the peripheral blood smear.
- Conditions associated with increased concentrations of globulins and/or fibrinogen
- Waldenstrom's ,macroglobulinemia
- Multiple myeloma
- Chronic inflammatory disorders
- Clusters of RBCs due to antigen/antibody reactions in vivio
- Cannot distinguish the outlines of individual RBCs
- Cold agglutinins (most often IgM antibodies)
- Paroxysmal cold hemoglobinuria
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