Description:

Pelger-Huët anomaly is inherited as a dominant trait, characterized by incomplete lobulation of the nucleus of eosinophilic and neutrophilic granulocytes. If the neutrophils are “pelgerized”, all the other blood cells are to some extent affected. In the peripheral blood smear, almost all granulocytes are in the stab form.

Shape:

More than 90% neutrophilic granulocytes of persons homozygous for the defect contain single round nuclei with picnotic chromatin or nuclei containing up to 10 large rough particles of the chromatin.
Granulocytes with bisegmented nucleus are found in 98% of the heterozygotes.

Description:

This is an acquired anomaly, appearing in infection (infectious mononucleosis), malignant diseases (myelodysplasias, chronic myeloid leukemia), or metastases in the bone marrow.
It is manifested as limited segmentation of the nucleus of leukocytes.

Shape:

Pseudo Pelger-Huët cells are ordinary neutrophils the nuclei of which have taken on forms very similar to those of a heterozygous Pelger cell, due to the influence of regenerative stimuli.

Description:

It can be hereditary (> 80% in the homozygotic form, and about 60% of neutrophilic granulocytes in the heterozygotic form), or acquired anomaly. The acquired anomaly can be seen in blood smears in megaloblastic anemia. In vitamin B12 or folate deficiency, large neutrophilic granulocytes more than 16 µm in diameter coexist with hypersegmentation.

Shape:

The nucleus in the hereditary hypersegmentation of granulocytes has more than three lobes with fine chromatin. Neutrophils contain a nucleus with four and more segments.

Description:

In Alder’s anomaly, the cytoplasm of neutrophils contains prominent granules that stain deep lilac. The inheritance pattern of this disorder is not clear but may be part of a general metabolic disorder of mucopolysaccharides.     

Shape:

The granules are large, with violet-black Pappenheim staining. This anomaly gives rise to deep purple granules in neutrophils. Similar abnormal granules are found in other granulocytes, monocytes, and lymphocytes.

Description:

This anomaly is caused by a shortage of lysosomes, which leads to giant granules. Bizarre giant granules are found in the cytoplasm of all types of leukocytes and their precursors. It appears in neonatal age and during the first year of life.

Shape:

Acid phosphatase accumulates in lysosomes; it is very stable and degranulates bactericidal activity. Granulocytes are inert, react poorly to the chemotactic stimulus, and mainly remain in the bone marrow. That is why distinct granulocytopenia is present in the peripheral blood. In the cytoplasm of neutrophilis there are giant granules.

Description:

It is a rare autosomal dominant disorder characterized by well-defined, large basophilic inclusions in neutrophils, eosinophils, basophils, monocytes, and giant platelets. The inclusions are similar to Döhle bodies observed in infections and appear to consist mainly of RNA. However, they differ from Döhle bodies morphologically and are present in granulocytes other than neutrophils.

Shape:

The inclusions resemble Döhle bodies and are frequently confused with them. The inclusion consists of aggregates of very fine, filamentous structure. They are seen in 3-100% of platelets in the May-Hegglin anomaly. Their significance is unknown.

Description:

Döhle bodies are formed from free ribosomes or more commonly from ribosomes attached to parallel sacs of endoplasmic reticulum. They contain a large amount of RNA. Döhle bodies are found in haematologic diseases, malignant diseases, aplastic anemias, chemoterapy, infections (scarlet fever), and toxic states.
They may be seen in the cytoplasm of neutrophils from patients with infections, burns, myelodysplasia, and in pregnancy. They contain rough-surfaced endoplasmic reticulum. Similar blue inclusions are seen in patients with May-Hegglin anomaly, but these are usually larger and have more sharply defined borders.

Shape:

Döhle bodies are light blue round or oval bodies about 1-2 µm in diameter.
They stain greenish-blue with Pappenheim.

Description:

In some patients the granules of the neutrophils appear larger than normal and stain more darkly, often assuming a dark blue-black color. This has been called toxic granulation. They can be found in neutrophilic granulocytes of the patients with severe infection or intoxication.

Shape:

These are large primary azurophilic granules. In the blood smear, the granules are much coarser and their staining reaction is more acidophilic than in normal granulocytes. Toxic granulation is often well seen in developing granulocytes, especially in the myelocytes.

Description:

These are neutrophils with an appendage on the nucleus specific for the sex.
The nucleus of neutrophils from females may have an appendage that is shaped like drumstick and is attached to one lobe by a strand of chromatin.
In healthy people “drumstick” is present in 2-3% of neutrophils. By hemozygotes this anomaly is seen in 35% of neutrophils, and by heterozygotes in 13% of neutrophils.

Shape:

Nuclear spicules or appendages attached by a broad base occur in normal individuals, but may be increased in number in chronic illnesses or after cytotoxic or radiation therapy. Such appendages do not occur in the neutrophils of men.

Description:

These are abnormally large elongated azurophilic granules containing peroxidase, lysosomal enzymes, and large crystalline inclusions. They are the result of abnormal development of primary azurophilic granules. These are rod-shaped structures that appear in the cytoplasm of myeloblasts, promyelocytes, monoblast, or monocytes (not in lymphoblasts or lymphocytes) in the patients with myeloblastic leukemia. They are an important diagnostic indicator for differentiating myelocytic leukemia from other leukemias.

Shape:

They are large elongated, rod shaped structures.

Description:

Pathological stimuli often lead to an increase in the number of staff forms in the blood: more immature stages of development, myelocytes and promyelocytes may also appear in the peripheral circulation. Thus, in acute infective diseases the number of unsegmented neutrophils may increase by 50% or more. This shift is usually recorded as (+) or (++).

Shape:

Description:

They are frequent in vitamin B12 or folate deficiency. In this case metamyelocytes are larger than normal. Macropolycytes may be noticed in chronic infections as well as in myeloproliferative diseases.

Shape:

Large giant neutrophilis with a diameter of more than 16 µm, with hypersegmentation of the nucleus containing 6-14 lobuli.

Description:

Neutrophilis are markedly smaller than normal ones and they can be seen in patients with severe intoxication and hemoblastosis.

Shape:

Neutrophilis are markedly smaller than normal.