Manabat, Ayra Celine Gem S.

A. NUCLEAR

1. Hypersegmentation (≥ 6 lobes)

a. Hereditary

• autosomal dominant

b. Acquired

• Megaloblastic anemia

2. Hyposegmentation

• Neutrophil is bilobed showing a dumbell,

specktacle-like, peanut-shape, or “Pince

nez” shape

a. Pelger Huet Anomaly

• Autosomal dominant

b. Pseudo Perger Huet (acquired)

• Myeloproliferative disorder like CML

B. CYTOPLASM

a. Alder Reilly Inclusions

• Accumulation of degreaded mucopolysaccahrides resembling toxic granulation.

• Ex. Alder-Reilly Anomaly, Hunter’s / Hurler’s Syndrome

b. Auer Rods

• Fused primary granule; peroxidase (+)

• Seen in a:
• myeloblast in AML
• monoblast in AMML
• FAGGOT CELLS are cells with mass of Auer rods usually seen in M3

c. Chediak-Higashi Inclusion

• Large azurophilic or purplish-red granules

• “lysozyme defect”
• seen in lymphocyte, neutrophil, monocyte
• autosomal recessive
• associated with ALBINISM
• platelet lack DENSE granules

d. May-Hegglin Inclusion

• Pale blue inclusion derived from RNA (confused with Dohle Bodies)
• May Hegglin Anomaly – autosomal dominant; associated with thrombocytopenia and GIANT PLATELETs.
e. Dohle Bodies

• Aggregates of free ribosomes of rough ER seen in severe infections and toxic states.
• Single multiple blue inclusions

f. Toxic granules

• Large purple to black granules

• Seen in infections and toxic states

g. Toxic Vacuoles

• Seen in severe infection and toxic states

C. FUNCTION

a. Job’s Syndrome

• NORMAL random activity

• ABNORMAL chemotactic activity

b. Lazy Leukocyte Syndrome

• ABNORMAL both random and chemotatic activity

c. Chronic Granulomatous Disease (CGD)

• Mobility of neutrophil to kill ingested microorganism.

• Impaired NADPH Oxidase / Oxidative Metabolism / Respiratory Burst
• Test: Nitroblue Tetrazolium Test (NBT)

D. CELLS EXHIBITING PHAGOCYTOSIS

a. LE Cell

• a NEUTROPHIL with homogenous

round body; smooth and evenly stained

b. Tart Cell

• a MONOCYTE with ingested

lymphocyte; rough and unevenly stained

*buffy coat is needed

E. LYMPHOCYTE ABNORMALITIES

a. Atypical Lymphocyte / Reactive / Variant /

Stimulated Lymphocyte / Virocyte / Downey

• Type I

• Turks irritation or Plasmacytoid Lymphocyte

– With large block of chromatin

• Type II

– Associated with IM

– With round mass of chromatin

– “Ballerina-skirt” appearance

• Type III

– Vacuolated

– “Swiss Cheese or Moth Eaten” Appearance

b. Basket Cell / Smudge Cell

Seen in:

• Pressure in wedge smear preparation; usually the remedy is the addition of BOVINE ALBUMIN.
• Chronic Lymphocytic Leukemia (CLL) where in there is an increase in Smudge cell.

c. Hairy Cells

• “salt and pepper chromatin”

• Lymphocyte with hair-like cytoplasmic projections surrounding nucleus, thought to be of B cell origin.
• (+) Tartrate Resistant Acid Phosphatase

d. Sezary Cells

• Lymphocyte with cerebriform nucleus (brain-like nucleus)

• Seen in : Mycosis Fungoides and Sezary Syndrome

F. PLASMA CELL ABNORMALITIES

a. Flame Cell

• Red or pink cytoplasm

• Increase cytoplasmic Ig (usually IgA)
• Seen in Multiply myeloma

b. Russel Bodies

• Individual globules of Ig

c. Grape / Berry / Morula Bodies

• MOTT CELL – accumulation or Russel

• Bodies; seen in Multiple Myeloma

d. Dutcher’s Bodies
 • Intranuclear protein inclusions

G. ABNORMAL MONOCYTES / MACROPHAGE /

HISTIOCYTES

a. Gaucher’s Disease

• Deficient GLUCOCEREBROSIDASE or BETA-GLUCOSIDASE

• Accumulation of glucocerebroside
• Characterized by: “wrinkled paper or crumpled cytoplasm”

b. Niemann-Pick

• Deficient SPHINGOMYELINASE
• Accumulation of sphingomyelin
• FAOMY cytoplasm

c. Tay-Sach’s

• Deficient HEXOAMINIDASE A
• Accumulation of glycolipid and ganglioside
• Vacuolated cytoplasm

d. Sandhoff

• Deficient HEMOAMINIDASE A and B

• Accumulation of glycolipid and ganglioside
• Vacuolated cytoplasm
• e. Sea Blue Histiocytosis
• Unknown deficiency
• Blue-green cytoplasm