Quick Review Cards for Medical Laboratory Science

Leukocyte Abnormalities Hematology Review 316

ABNORMALITY DESCRIPTION SIGNIFICANCE

Shift to the left

Toxic granulation

Döhle bodies

Vacuolization

Hypersegmentation

Pelger-Huët anomaly

Auer rods

Variant lymphocytes

(atypical or reactive)

Presence of immature granulocytes in peripheral blood

Dark-staining granules in cytoplasm of neutrophils

Light blue patches in cytoplasm of neutrophils

Phagocytic vacuoles in cytoplasm of neutrophils

>5 % of segs with 5-lobed nuclei or any with >5 lobes

Most neutrophils have round or bilobed nuclei

Red needles in cytoplasm of leukemic myeloblasts &

occasionally promyelocytes & monoblasts

1 or more of following: large size, elongated or indented

nucleus, immature chromatin, ↑parachromatin,

nucleoli, ↑cytoplasm, dark blue or very pale cytoplasm,

peripheral basophilia, scalloped edges due to indenta-

tion by adjacent RBCs, frothy appearance, many

azurophilic granules

Bacterial infection, inflammation.

Infection, inflammation.

Infection, burns.

Septicemia, drugs, toxins, radiation.

One of 1st signs of pernicious anemia.

Inherited disorder. No clinical effect. May be

misinterpreted as shift to left.

Rules out lymphocytic leukemia. Seen in up to

60% of patients with AML. From abnormal fu-

sion of primary granules.

Viral infections (e.g., IM, CMV).

IM = infectious mononucleosis, CMV = cytomegalovirus.