Howell-Jolly Bodies

By William Aird

Howell-Jolly body in a red cell (arrow) of a 56-year-old man who previously had traumatic splenectomy; B, burr cell; P, platelet (100x, oil)

Howell-Jolly body in red cell (arrow) of a 23-year-old man with sickle cell disease with functional hyposplenism; S, sickle cells (boat cells) (100x, oil).

Howell-Jolly body in red cell (arrow) of an 80-year-old man with history of splenectomy; H, horn cell (100x, oil).
Red blood cell, inclusionHowell-Jolly body
DefinitionHowell-Jolly bodies are small round purple inclusions in RBCs about 1 μm in diameter. Compared to Pappenheimer bodies, Howell-Jolly bodies are larger in size, have smooth outlines, typically one per RBC, and are comprised of DNA.
DdxPlatelet overlying a red cell, Pappenheimer bodies, artifact.
Conditions associated with the inclusionAsplenia (post-splenectomy, functional hyposplenia)
Mechanism of formationThey are formed in the process of red cell nuclear karyorrhexis or when an aberrant chromosome becomes separated from the mitotic spindle and remains behind when the rest of the nucleus is extruded. Normally, the spleen is very efficient in removing Howell-Jolly bodies from red cells, but if the spleen is missing or hypofunctioning, they may be readily found in the peripheral blood.
HistoryHowell 1890 showed extrusion of red cell nucleus; Jolly reported his findings of these inclusions in 1907 (learn more here).
Source/authorWilliam Aird
Reviewed and edited byParul Bhargava
ReferencesAm J Med Sci 2012;343:407