STEPTRACKERCROSS-SYSTEM | HISTOPATHOLOGY | RAPID-FIRE REVIEW

Inclusions & Eponymous Bodies

Named bodies, cells, crystals and patterns seen under the microscope — what each one is made of and where it appears.

FOCUS ON
Know what each body is (protein aggregate, viral inclusion, organelle, calcification, cell) — exam stems describe the appearance. Many come in look-alike pairs: Schiller-Duval vs Call-Exner, Homer-Wright vs perivascular pseudorosettes, Councilman vs Mallory-Denk, Lewy vs Pick.
BODY · CELL
WHAT IT IS
DISEASE
PAGE
Reed-Sternberg cell
Large binucleate "owl-eye" B cell; CD15, CD30 ⁺
Hodgkin lymphoma
6.08
Auer rods
Fused azurophilic granules (needle-shaped)
AML, especially APL (DIC risk)
6.02
Ringed sideroblasts
Iron-loaded mitochondria around the nucleus of erythroblasts
Sideroblastic anemia (ALAS2, lead, alcohol, B6)
5.04
Heinz bodies · bite cells
Denatured hemoglobin · pitted by splenic macrophages
G6PD deficiency
5.08
Howell-Jolly bodies
Nuclear remnants in RBCs not removed by the spleen
Asplenia, sickle cell autosplenectomy
5.11
Basophilic stippling
Aggregated ribosomes in RBCs
Lead poisoning, thalassemia
5.04
Russell · Dutcher bodies
Immunoglobulin in cytoplasm · in nucleus of plasma cells
Plasma cell neoplasms, chronic inflammation
6.09
Aschoff bodies · Anitschkow cells
Granuloma with fibrinoid necrosis · "caterpillar" macrophages
Rheumatic carditis
8.08
Curschmann spirals · Charcot-Leyden crystals
Shed epithelium in mucus · eosinophil galectin-10 crystals
Asthma
9.05
Ferruginous bodies
Asbestos fibers coated with iron and protein (golden, beaded)
Asbestosis
9.06
Asteroid · Schaumann bodies
Star-shaped inclusions in giant cells · laminated calcifications
Sarcoidosis
9.07
Councilman bodies
Apoptotic, eosinophilic hepatocytes
Viral hepatitis, yellow fever
11.06
Mallory-Denk bodies
Aggregated cytokeratin intermediate filaments in hepatocytes
Alcoholic hepatitis, NASH, Wilson
11.07
Owl-eye · Cowdry A inclusions
Intranuclear viral inclusions
CMV (owl eye, enlarged cells) · HSV/VZV (Cowdry A, multinucleated)
10.03
Negri bodies
Eosinophilic cytoplasmic viral inclusions in neurons
Rabies (Purkinje cells, hippocampus)
16.07
Lewy · Pick · Hirano bodies
α-synuclein · tau spheres · actin rods
Parkinson/Lewy dementia · frontotemporal dementia · Alzheimer
16.09
Rosenthal fibers · Verocay bodies
Eosinophilic corkscrew GFAP fibers · palisading nuclei around fibrillary zones
Pilocytic astrocytoma · schwannoma
16.12
Psammoma bodies
Laminated dystrophic calcifications
Papillary thyroid, serous ovarian, meningioma, mesothelioma
15.05
Schiller-Duval · Call-Exner bodies
Glomeruloid structures · follicle-like rosettes with eosinophilic fluid
Yolk sac tumor (AFP) · granulosa cell tumor (estrogen, inhibin)
13.07
Reinke crystals
Rod-shaped eosinophilic crystals
Leydig cell tumor
14.04
Birbeck granules
Tennis-racket organelles on EM; CD1a, langerin ⁺
Langerhans cell histiocytosis
17.04

Rosettes and look-alikes

PATTERN
DESCRIPTION
TUMOR
Homer-Wright rosette
Cells around a fibrillary center, no lumen
Medulloblastoma, neuroblastoma
Perivascular pseudorosette
Cells around a blood vessel
Ependymoma
Flexner-Wintersteiner rosette
Cells around a true lumen
Retinoblastoma
Pseudopalisading necrosis
Tumor cells lined up around necrosis
Glioblastoma
Peripheral palisading
Nuclei lined up at nest edges
Basal cell carcinoma
Keratin pearls
Concentric keratin whorls
Squamous cell carcinoma

Cells with a name

CELL
LOOK
DISEASE
Signet ring cell
Mucin pushes nucleus aside
Diffuse gastric cancer, Krukenberg
Koilocyte
Raisinoid nucleus, perinuclear halo
HPV infection
Hürthle cell
Large oncocytic follicular cell
Hashimoto, Hürthle neoplasms
Gitter cell
Lipid-laden microglia
Brain infarct (days 3–5)
Red neuron
Eosinophilic shrunken neuron
Ischemia at 12–24 h
Smudge cell
Fragile lymphocyte crushed on smear
CLL

How it's tested

COMMON CONFUSIONCouncilman bodies (apoptotic hepatocytes in viral hepatitis) vs Mallory-Denk bodies (cytokeratin tangles in alcoholic hepatitis) — both eosinophilic, different causes.
THE TRAPPsammoma bodies point to several tumors, not one. Use the organ and patient to pick: thyroid nodule, ovarian mass, dural mass or pleural rind.
YOUR APPROACHDescribe the body (where in the cell, what color, what shape) → what it is made of → which disease → what that disease does next.

If you see… think…

Owl-eye binucleate cell in a lymph node → Reed-Sternberg (Hodgkin)
Needle-like red rods in myeloblasts → Auer rods (AML/APL)
Golden beaded fibers in lung → ferruginous bodies (asbestos)
Eosinophilic cytokeratin tangles in hepatocytes → Mallory-Denk bodies
Intracytoplasmic inclusions in Purkinje cells → Negri bodies (rabies)
Round intraneuronal tau inclusions in frontal cortex → Pick bodies
Corkscrew eosinophilic fibers in a cerebellar tumor → Rosenthal fibers
Glomerulus-like structures in an ovarian tumor with ↑ AFP → Schiller-Duval bodies
Laminated calcified spheres in a thyroid nodule → psammoma bodies (papillary)
Tennis-racket granules on EM → Birbeck granules (LCH)