Morphological abnormalities of white cells

Morphological abnormalities of white cells
Updated: 08/09/2024
© Jun Wang, MD, PhD

Alder-Reilly anomaly
  • Metachromatic granules surrounded by clear zonein lymphocytes
  • Dark granules similar to toxic granulation in all white cells
  • Associated with the genetic mucopolysaccharidoses
  • Lack the lysosomal enzymes necessary to break down mucopolysaccharides
Döhle bodies
  • Single or multiple blue cytoplasmic inclusions in neutrophils
  • Remnants of rough endoplasmic reticulum retained from a more immature state
  • Associated with myeloid "left shifts"
Hypersegmentation
  • Abnormally increased nuclear lobulation in granulocytes
  • Associated with megaloblastic anemia
May-Hegglin anomaly
  • Autosomal dominant
  • Dohle-like bodies and background giant platelets
  • May be associated with thrombocytopenia and bleeding
Pelger-Huet anomaly
  • Autosomal dominant
  • Less segmentation of granulocyte nuclei
  • Round (homozygote) or bilobed nuclei (heterozygote) in neutrophils
  • Normal cell function
Pseudo-Pelger-Huet change
Toxic granulation
  • Prominence of dark coarse azurophilic granules in neutrophils
  • Usually in severe inflammatory
  • Commonly seen with left shift
  • Associated with rapid generation of granulocytes

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