Variations in White Cell Morphology: Granulocytes

Authors: Marjorie A. Spahn, MLS(ASCP) and Barbara Minderman, MLS(ASCP)
Reviewer: Joshua J. Cannon, MS, MLS(ASCP)CMSHCM
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Continuing Education Credits

P.A.C.E.® Contact Hours: 1 hour(s)

Florida Board of Clinical Laboratory Science CE Credit Hours

Florida Board of Clinical Laboratory Science CE - General (Hematology): 1 hour(s)

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This course covers all aspects of white blood cell morphology, including identifying changes in morphology in granulocytes. Addresses Barr bodies, Dohle bodies, Auer rods, vacuoles, hypersegmented granulocytes, and hyposegmented granulocytes. Excellent as a refresher or for clinical laboratory science students.

Objectives

  • Explain the importance of identifying changes in granulocyte morphology.
  • Define, describe, and explain the relationship of Barr bodies to abnormal morphology.
  • Discuss nuclear hypersegmentation and hyposegmentation, with respect to: definition, appearance, composition, and significance.
  • Discuss nuclear hypersegmentation and hyposegmentation, with respect to: hypersegmented granulocytes and hyposegmented granulocytes.
  • Identify each of the following cytoplasmic variations: Dohle bodies, Auer rods, vacuoles, and abnormal granulation.
  • Identify and describe the morphological changes associated with Pelger-Huet anomaly, Chediak-Higashi anomaly, Alder-Reilly anomaly, and May-Hegglin anomaly.

Course Outline

  • Introduction
    • Variations in Morphology
    • Importance of Recognition
    • Match the following:
  • Nuclear Variations
    • Hypersegmentation
    • Conditions Associated with Hypersegmented Neutrophils
    • Hypersegmented Neutrophil versus Normal Segmented Neutrophil
    • Which of the following statements is true for hypersegmented neutrophils?
    • Hyposegmentation
    • Conditions Associated with Hyposegmented Neutrophils
    • Pelger-Huet Anomaly
    • Normal Band Forms versus Pelger-Huet Bands
    • Bi-lobed Neutrophil
    • Pelger-Huet Cells
    • Single-Lobed Pelger-Huet Cells
    • Which of the following are seen in Pelger-Huet anomaly?
    • Barr Body
    • Which of the following best describes a Barr body?
    • Summary
  • Cytoplasmic Variations
    • Döhle Bodies
    • Döhle Bodies, continued
    • Toxic Granulation
    • Toxic Granulation and Vacuolation
    • Cytoplasmic Vacuolation
    • Neutrophil with Normal Granulation
    • Toxic granulation is seen most frequently in:
    • Auer Rods
    • Auer Rods, continued
    • Which of the following inclusions may be seen in the cytoplasm of myeloblasts and promyelocytes?
    • Auer rods are significant when they are seen in the cytoplasm of blast cells because they are diagnostic for:
    • Chédiak-Higashi Syndrome
    • Albinism and Chédiak-Higashi Syndrome
    • Chédiak-Higashi Syndrome versus Toxic Granulation
    • Chediak-Higashi Syndrome Inclusions
    • Chediak-Higashi Syndrome is characterized by which of the following?
    • May-Hegglin Anomaly
    • Alder-Reilly Anomaly
    • Alder-Reilly Anomaly, continued
    • Alder-Reilly anomaly inclusions may be found in which of the following white blood cell types?
    • Which of the following inclusions has a similar appearance on a Wright's stained smear to a Döhle body?
    • The inclusions that are frequently seen on the same peripheral blood smear with toxic granulation include:
    • What type of inclusions are present in the cell that is indicated by the arrow?
    • The cell in this image is typical of other neutrophils on this peripheral blood smear from a patient with sepsis. Which morphologic term describes the cellular morphology in this image?
    • Summary
  • References
    • References

Additional Information

Level of Instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Authors: Marjorie A. Spahn, MLS(ASCP) and Barbara Minderman, MLS(ASCP).
Reviewer Information: Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor of Science and Master of Science in Medical Laboratory Science from Thomas Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist and Specialist in Hematology certifications through the ASCP Board of Certification. He was a professor at Thomas Jefferson University for seven years before transitioning into his current role as Education Developer at MediaLab. His areas of expertise and professional passions include clinical hematology and interprofessional education.
Course Description: This course covers morphologic variations observed in granulocytes, including nuclear and cytoplasmic variations.