granulocyte cytoplasmic abnormalities

Question 1

• found in dead neutrophils/necrobiotic neutrophils; they are rounded nuclear fragments with no filaments and no chromatin pattern

Answer 1

necrotic cells

Question 2

• Appears as dark, blue-black granules in the cytoplasm of neutrophils, usually in segmented and band forms
• Granulation may represent the precipitation of ribosomal protein (RNA) caused by metabolic toxicity within the cells
• Are peroxidase positive and reflect an increase in acid mucosubstance within primary, azurophilic granules that may enhance bactericidal activity
• The extent of granulation is usually graded on a scale of 1+ to 4+, with 4+ being the most severe. Grading of the granulation is dependent on the coarseness and amount of granulation within the cellular cytoplasm
• Primary granules are larger than secondary granules

Answer 2

toxic granulations

Question 3

Increased numbers suggest that an extended amount of time has elapsed between blood collection and blood film preparation

Answer 3

pyknotic and necrotic cells

Question 4

cytoplasmic vacuolations

• Tend to be small (approximately 2 um) and distributed throughout the cytoplasm
• can be induced by specimen storage in ethylenediamintetraacetic (EDTA) for more than 2 hours, autoantibodies, acute alcoholism, and exposure to high doses of Radiation

Answer 4

autophagocytic vacuoles

Question 5

• Less encountered than toxic granules and Dohle bodies
• Reflect phagocytosis, either of self (autophagocytosis) or of extracellular material

Answer 5

cytoplasmic vacuolations

Question 6

• Pink or red shaped cytoplasmic granules; found in myeloid and monocytic series only
• Fused primary granules (Peroxidase stain positive)
• Faggot cells
• Seenin acute promyelocytic leukemia (APL) or M3; also associated with DIC

Answer 6

auer rods

Question 7

• Acute myelogenous leukemia (AML, M1 and M2)
• Acute promyelocytic leukemia (APL, M3)
• Acute myelomonocytic leukemia (AMML, M4

Answer 7

auer rods

Question 8

• Is a result of osmotic swelling of the cytoplasm or by increased adhesion to the glass slide in stimulated neutrophils
• Regardless of the cause, the result is a variation in neutrophil size or neutrophil anisocytosis

Answer 8

cytoplasmic swelling

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Question 9

• generally indicate imminent cell death
• water has been lost and the chromatin becomes dense and dark; however, chromatin or filaments can still be seen between nuclear lobes (depending on whether the cell is a band or segmented form)

Answer 9

pyknotic cells

Question 10

• Giant red, blue, to grayish round inclusions in the cytoplasm
• Giant lysosomal granules in granulocytes, monocytes, and lymphocytes
• Cells in the body are affected and exhibit abnormally large lysosomes, which contain fused dysfunctional granules

Answer 10

chediak-higashi granules

Question 11

• Are small, obligate, intracellular bacteria transmitted by ticks to humans and other vertebrate hosts
• These organisms grow as a cluster (morulae) in neutrophils and monocytes
• Morulae can be mistaken for Dohle bodies in neutrophils

Answer 11

ehrlichia and anaplasma

Question 12

Mucopolysaccharidoses (MPSs)

Answer 12

alder-reilly granules

Question 13

• Darkly staining metachromatic (purple-red) cytoplasmic granules in granulocytes (less often in monocytes and lymphocytes)
• Abnormal large primary granules
• Granules contain degraded mucopolysaccharides due to an enzyme defect
• May resemble toxic granules (seen in infections and toxic states)

Answer 13

alder-reilly granules

Question 14

• Are light/pale blue round or elongated cytoplasmic inclusions between 1-5 um consisting of remnants of ribosomal ribonucleic acid (rRNA) arranged in parallel row; close to cellular membranes
• Are typically found in band and segmented neutrophils and can appear together with toxic granulations; can be seen in eosinophils, basophils, monocytes, and lymphocytes
• Localized failure of cytoplasmic maturation
• PAS reaction positive
• Adelay in preparing the blood film after collection may affect appearance in that they are more grey than blue or in some cases may not be visible
• Confused with May-Hegglin granules

Answer 14

dohle-bodies/dohle-amato bodies

Question 15

• a fungus; this organism lives intracellularly in cells of the mononuclear phagocyte system, cells of the bone marrow, or cells from sputum or effusion specimens
• The fungus appears as a tiny oval body with a clear halo surrounding a small nucleus

Answer 15

histoplasma

Question 16

• CAN MIMIC GRANULATION FOUND IN ALDER-REILLY ANOMALY
• one helpful defining characteristic is that in most cases, not all neutrophils are equally affected

Answer 16

toxic granulations

Question 17

transmitted by the black-legged tick (Ixodes scapularis) and the western black-legged tick (I. pacificus)

Answer 17

human granulocytic ehrlichiosis (HGE)

Question 18

• Bacterial infection
• Drug intoxication

Answer 18

pyknotic and necrotic cells

Question 19

cytoplasmic vacuolations

• Tend to be large (up to 6 um) and often accompanied by toxic granulation
• Induced by either bacteria or fungi are suggestive of sepsis
• When seen, a careful examination sometimes reveals organisms within the vacuoles

Answer 19

phagocytic vacuoles

Question 20

• Inflammations
• Infections
• Toxic states
• Burns
• Malignant disorders

Answer 20

toxic granulations

Question 21

• Infections
• Pregnancy
• Burns
• Toxic states

Answer 21

dohle-bodies/dohle-amato bodies

Question 22

• Acute myeloid leukemia
• Chronic myeloid leukemia
• Myelodysplastic syndrome (MDS)

Answer 22

chediak-higashi granules

Question 23

• Gray-blue spindle shaped inclusions in the cytoplasm
• Large Dohle body-like inclusions in neutrophils, eosinophils, basophils, and monocytes
• The basophilic Dohle body-like leukocyte inclusions are composed of precipitated myosin heavy chains (mRNA)
• True Dohle bodies consist of lamellar rows of rough endoplasmic reticulum (rRNA)

Answer 23

may-hegglin granules