Qualitative WBC Disorders Toxic granulation vacuolation Presence noted

Qualitative WBC Disorders

Toxic granulation, vacuolation Presence noted in; • Severe bacterial and viral infections • G-CSF or GM-CSF therapy • Acute alcohol poisoning • Diabetes mellitus • Aplastic anemia

Reduced granulation Presence noted in; • MDS and AML • Congenital lactoferrin (specific granule) deficiency

Döhle bodies or similar inclusions Dohle Bodies; Single or multiple blue–grey cytoplasmic inclusions. Associated with "left shifts" + toxic granulation. Presence noted in; • Infection • Inflammation • Burns • Pregnancy • MDS and AML

Phagocytosed material Presence noted in; • Bacteria • Parasites: Leishmaniasis • Nucleoprotein (LE cell) : SLE • Erythrocytes: AIHA Bacteria

Hypersegmentation Presence noted in; • Megaloblastic anemia • Infection • Myelodysplastic syndrome Note: The macropolycyte is twice as large as the normal neutrophil and has a nucleus with 7 or 8 lobes.

Hyposegmentation Presence noted in; • Pelger–Huët anomaly • MDS and AML • Infection

Necrobiotic WBC Presence noted in; • Chemotherapy • Poorly preserved specimen

Shift to the left (Left Shift) Presence noted in; • Pregnancy • Infection • CML

Nuclear Appendages

Barr body

Auer rods

Leukoerythroblastic reaction leukocytosis + left shift + n. RBC)

Leukemoid Reaction Excessive leukocytosis (WBC > 50. 000/μl) + exaggerated neutrophilia + left shift

Activated lymphocytes

Normal Lymphocyte