9B

Question 1

What are Dohle bodies

Answer 1

In septicemia, the BM gets stimulated to produce neutrophils at a faster rate and therefore the neutrophils
have to come out of the B.M before they are completely mature. Thus the cytoplasm of
such cells contains more RNA and primary granules. The residual RNA occurs in small
islets knows as Dohle bodies. Dohle bodies appear as small light blue staining areas in
the cytoplasm of neutrophils, near the cytoplasmic membrane.

Question 2

What are toxic granules

Answer 2

The primary granules which persisted in large numbers have been called by mistake
“toxic granules”, but these are in fact the promyelocyte granules which have persisted till
the late stage because the neutrophil didn’t have enough time to lose them, or due to
skipped divisions during the development of the neutrophil

Question 3

What is Hereditary hypersegmentation

Answer 3

This is an autosomal dominant condition resulting in hypersegmentation of the neutrophil
above 5 segments. This condition which is rare, is entirely harmless (not associated with
any disease) and is seen in all neutrophils.

Question 4

What is Pelger-Huet anomaly

Answer 4

This is an autosomal dominant condition resulting in hyposegmentation of the
neutrophils. So there is a mutation in the gene that controls segmentation of neutrophils
that results in failure of the neutrophil to segment. Here the patient could be homozygout
or heterozygout. In the homozygout state, the nucleus remains rounded (unsegmented). In
the heterozygout state, the nucleus is bilobed (dumb-bell shape). All neutrophils have no
more than a bilobed nucleus. In both conditions, the nuclear chromatin is coarsely
clumped. This condition is entirely harmless and neutrophils appear to function normally.

Question 5

Why should we be careful about properly diagnosing Pelger-Huet?

Answer 5

It is of practical importance to recognize the Pelger Huet Anomaly so that it is not
confused with a shift to the left. These cells are fully mature cells that look
morphologically immature because they are not segmented or because they are
hyposegmented.

Question 6

What is the difference between May-Hegglin anomaly and Dohle bodies ?

Answer 6

• Dohle bodies are harmless while May-Hegglin anomaly might cause hemorrhagic problems or put the person at a higher risk of infection
• May- Hegglin inclusions are larger and more discrete (round or spindle shaped)
• May- Hegglin inclusions may be found in all types of cells not just neutrophils

Question 7

What is common between May-Hegglin bodies and Dohle bodies

Answer 7

Both are RNA reminants due to immature release of cells

Question 8

What are Alder-Reilly bodies?

Answer 8

This is also an inherited abnormality of granulocyte morphology; it is inherited as an
autosomal recessive trait and is characterized by the presence of abnormally large
azurophilic and basophilic granules resembling severe toxic granulation in the cytoplasm
of granulocytes, monocytes and lymphocytes. These inclusions do not appear to affect
function and are referred to as Alder-Reilly bodies. This anomaly may be seen in
association with a group of storage diseases in which protein-carbohydrate complexes
called mucopolysaccharides accumulate in the cytoplasm of tissue and blood cells, due to
lack of the lysozymal enzymes necessary to break down these complexes.

Question 9

What is the Chediak- Higashi Anomaly

Answer 9

• characterized by abnormal killing
• very important anomaly but it is very rare it is very serious
• associated with increased susceptibility to infections and bleeding tendencies (with normal platelet counts but abnormal platelet function).
• autosomal recessive gene
• characteristic feature of it is that the granules of all granular cells of the body tend to fuse and form large granules.

Question 10

How do granules fuse in each of neutrophils, lymphocytes, and proerythroblasts due to Chediak-Higashi anomaly

Answer 10

 In neutrophils, we see fusion of 1o and 2o granules to form extremely coarse
structures (make sure to differentiate them from toxic granules). So instead of
having fine granules, we will have 10-15 huge granules in the neutrophils.
 The lymphocyte shows fusion of the non-specific granules into a single huge
solitary granule.
 Promyelocytes in the BM, show the most remarkable fusion where the 1o granules
fuse to form 3-4 clumps surrounded by a vacuole and this is strictly characteristic.