The Production of Schistocytes by Fibrin Strands (A Scanning Electron Microscope Study)

The relationship between intravascular coagulation and schistocyte formation has been adequately documented in animal experiments and in in vitromodels. A case report is presented of a patient who suffered from micro-angiopathic hemolytic anemia during life as a result of disseminated gastricadenocarcinoma. The fibrin microclots found in his vasculature on postmortemexamination indicate that in intravascular coagulation, both in the human andin the experimental animal, fibrin initially polymerizes in the form of finefibrin strands. These strands, the main etiologic factor in producing schistocytes, are constantly being lysed or rendered amorphous, and rarely persistin postmortem tissues except under unusually favorable conditions. Postmortem histologic study of one case where such favorable conditions didexist indicates the essential identity of the pathologic process in man and inexperimental animals.

Submitted on May 26, 1969 Accepted on July 22, 1969