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 vitro models. A case report is presented of a patient who suffered from micro-angiopathic hemolytic anemia during life as a result of disseminated gastric adenocarcinoma. The fibrin microclots found in his vasculature on postmortem examination indicate that in intravascular coagulation, both in the human and in the experimental animal, fibrin initially polymerizes in the form of fine fibrin strands. These strands, the main etiologic factor in producing schistocytes, are constantly being lysed or rendered amorphous, and rarely persist in postmortem tissues except under unusually favorable conditions. Postmortem histologic study of one case where such favorable conditions did exist indicates the essential identity of the pathologic process in man and in experimental animals.