HEMA 311 Week 14 Lecture

Flashcards on Leukocyte Morphological Abnormalities

Hypersegmented Neutrophils

Neutrophils with more than five lobes, usually larger than normal; associated with megaloblastic anemia, Undritz anomaly, and myelodysplasia.

Hyposegmented Neutrophils

Hyposegmentation of granulocytes' nucleus; nuclei may appear round, ovoid (Homozygous Pelger-Huet) or bilobed (Heterozygous Pelger-Huet).

Pince-nez

Spectacle-like morphology of bilobed nuclei attached by a thin filament, characteristic of heterozygous Pelger-Huet anomaly.

LE Cell

Usually a neutrophil that has ingested the antibody-coated nucleus of another neutrophil; associated with Systemic Lupus Erythematosus and connective tissue disorders.

Barr Body

Represents the 2nd X chromosome in females; seen in 2-3% of neutrophils; characteristic “drumstick” appearance.

Alder-Reilly Granules

Darkly staining metachromatic (purple-red) cytoplasmic granules in granulocytes; contain partially digested mucopolysaccharides due to an enzyme defect; associated with Alder-Reilly anomaly and mucopolysaccharidoses.

May-Hegglin Granules

Gray-blue spindle shaped inclusions in the cytoplasm of granulocytes; composed of precipitated myosin heavy chains (mRNA); associated with May-Hegglin anomaly.

Chediak-Higashi Granules

Giant red, blue, to grayish round inclusions in the cytoplasm of granulocytes, monocytes, and lymphocytes; cells in the body are affected and exhibit abnormally large lysosomes; associated with Chediak-Higashi syndrome.

Auer Rods

Pink or red colored cytoplasmic granules; rod shaped; found in myeloid and monocytic series only; fused primary granules; associated with acute myelogenous leukemia (AML).

Toxic Granulation

Dark, blue-black granules in the cytoplasm of neutrophils; represents the precipitation of ribosomal protein (RNA) caused by metabolic toxicity; associated with inflammations, infections, and toxic states.

Döhle Bodies

Light/pale blue round or elongated cytoplasmic inclusions (remnants of ribosomal ribonucleic acid (rRNA)) arranged in parallel rows; associated with infections, pregnancy, burns, and toxic states.

Cytoplasmic Vacuolation

Small to large circular clear areas in cytoplasm; reflect phagocytosis; types include autophagocytic and phagocytic vacuoles; associated with bacterial infection, acute alcoholism, or excess storage of sample.

Pyknotic Cell

Dehydrated neutrophil nucleus with dense and dark chromatin, but with filaments still visible between lobes; indicates imminent cell death; associated with bacterial infection and drug intoxication.

Necrotic Cell

Dead neutrophil with rounded nuclear fragments with no filaments and no chromatin pattern; associated with extended time between blood collection and blood film preparation; associated with bacterial infection and drug intoxication.

Cytoplasmic Swelling

A variation in neutrophil size or neutrophil anisocytosis resulting from osmotic swelling of the cytoplasm or increased adhesion to the glass slide.

Ehrlichia and Anaplasma

Small, obligate, intracellular bacteria transmitted by ticks; grow as a cluster (morulae) in neutrophils and monocytes.

Histoplasma

A fungus that lives intracellularly in cells of the mononuclear phagocyte system; appears as a tiny oval body with a clear halo surrounding a small nucleus.

Basket/Smudge Cell

Degenerated nucleus or ruptured cell in form of basket/smudge; fragile lymphocytes that appear during smear preparation; associated with chronic lymphocytic leukemia.

Hairy Cell

Hair like cytoplasmic projections surrounding the nucleus (fried-egg appearance); TRAP stain positive; associated with hairy cell leukemia.

Sezary Cell

Lymphocyte with a convoluted nucleus/brain-like nucleus; indicates leukemic phase of mycosis fungoides (Sezary syndrome).

Reed-Sternberg Cell

Abnormal lymphocyte with an “owl’s eye appearance”; pathognomonic sign for Hodgkin’s lymphoma.

Rieder Cell

Lymphocyte with a clover leaf like nucleus; associated with chronic lymphocytic leukemia.

Reactive Lymphocyte

Lymphocytes stimulated when interacting with antigens in peripheral lymphoid organs; types include Turk’s cells and IM cells; associated with infectious mononucleosis, leukemias, and viral infections.

Flame Cell

Abnormal plasma cell with red to pink cytoplasm; associated with increased Immunoglobulins (usually IgA).

Grape Cell

Abnormal plasma cell with small colorless vacuoles; inclusions: Dutcher’s bodies (intranuclear protein inclusions); associated with multiple myeloma and reactive states.

Gaucher Cell

Distinctive macrophages with abundant fibrillar blue-gray cytoplasm with a striated or wrinkled appearance; associated with Gaucher’s disease.

Foam Cell

Macrophages with cytoplasm packed with lipid-filled lysosomes that appear as small vacuoles (foam) after staining; associated with Niemann-Pick’s disease.