Band neutrophil Information and Courses from MediaLab, Inc.
These are the MediaLab courses that cover Band neutrophil and links to relevant pages within the course.
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| Which is arranged from least mature to most mature: | View Page |
| Identify the nucleated blood cell: | View Page |
| Identify the nucleated blood cell: | View Page |
| Identify the nucleated blood cell: | View Page |
| Band Neutrophil Band neutrophils are also referred to as stab, staff, and band. Bands are the most immature form of the neutrophilic series found in normal peripheral blood. Their diameter is approximately 9-16 microns, and their N:C ratio is 1:2. | View Page |
| Appearance of a Band Neutrophil A band has moderate to abundant cytoplasm staining pale blue to pink. Present within the cytoplasm are fine lilac to pink granules. These specific granules, called neutrophilic granules, are small and somewhat resemble pencil stippling.
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| Identify the nucleated blood cell: | View Page |
| Identify the nucleated blood cell: | View Page |
| Identify the nucleated blood cell: | View Page |
| Nucleus of the Band Neutrophil The nucleus of a band neutrophil is sausage or band-shaped (U-shaped).Sometimes it appears folded or twisted, thus making identification more difficult.The nucleus stains a deep purplish-blue color, and the nuclear chromatin appears condensed, coarse, and clumped. | View Page |
| Maturing into Segmented Neutrophil As time progresses, the band nucleus gradually develops constrictions, resulting in the formation of nuclear lobes. In this way, the band neutrophil matures into a segmented neutrophil. | View Page |
| Identify the nucleated blood cell: | View Page |
| Identify the nucleated blood cell: | View Page |
| Identify the nucleated blood cell: | View Page |
| The nucleus of a small lymphocyte is about the same size as a: | View Page |
| Match the characteristics with the cell type. | View Page |
| Toxic Granulation Toxic granulation is manifested by the presence of large granules in the cytoplasm of segmented and band neutrophils in the peripheral blood. The color of these granules can range from dark purplish blue to an almost red appearance.
Toxic granules are azurophilic granules normally present in early myeloid forms, but which are not normally seen at the band and segmented stages of neutrophil maturation. These granules contain peroxidases and hydrolases.
Toxic granulation is seen in cases of severe infection, as a result of denatured proteins in rheumatoid arthritis or, less frequently, as a result of autophagocytosis. Infection is the most frequent cause of toxic granulation.
This type of granulation may be seen in cells which also contain Dohle bodies and/or vacuoles. Cells containing toxic granules may have decreased numbers of specific granules.
Cells containing only a few specific granules, with or without toxic granules, are said to be degranulated. The nucleus in degranulated cells may often be round-bilobed, smooth and pyknotic. This type of nucleus is the result of aging and will disintegrate soon.
Increased basophilia of azurophilic granules simulating toxic granules may occur in normal cells with prolonged staining time or decreased pH of the stain. | View Page |
| Band Neutrophil Showing Toxic Granulation A band neutrophil showing toxic granulation. The granules scattered throughout the cytoplasm are larger, more numerous and darker than those of normal neutrophils. | View Page |
| The cells included in the composite image were found in a peripheral blood smear with a total WBC of 24,500/mm3. The differential count was:
myelocytes 1
metamyelocytes 4
band neutrophils 15
segmented neutrophils 40
monocytes 8
eosinophils 2
basophils 1
lymphocytes 29.
This hematologic picture is most consistent with: | View Page |
| Assuming that other circulating neutrophils are similar to the band neutrophil in the photograph(see inclusion at arrow tip), which of the following conditions is most likely? | View Page |
| Normal Bone Marrow Cells A normal bone marrow smear stained with Wright/Giemsa stain is captured in this photograph.Note the normal maturation sequence beginning with myelocytes (the two large cells in the left upper corner)through metamyelocytes, band neutrophils,and multi-lobed segmented neutrophils.The small cells with darkly staining, centrally placed nuclei are normoblasts (three are clustered in the left lower field).Absent in this field are eosinophils, basophils and megakaryocytes.A normal M:E ratio of 2.4:1 is calculated from the twelve myeloid cells and five normoblasts. Two lymphocytes are identified, one left center, the other left upper. | View Page |
| The inclusions noted in the cytoplasm of this band neutrophil are most suggestive of: | View Page |
| A peripheral blood smear is submitted for morphology review. The patient is a 10 year-old boy with symptoms suggesting appendicitis and an appendectomy is being considered. The total WBC is 18.5 X 1000/uL, RBC's = 5.45 X 1M/uL, hemoglobin = 16.0 g/dL, hematocrit 48.2%;wbc differential: Segs = 53%, bands = 42% (two of which are shown in the photograph), monocytes = 2%, and lymphocytes= 2%. These findings support the diagnosis of appendicitis. | View Page |
| Case Follow-up Illustrated in the upper and lower photographs are two-lobed, eye glass ("pince nez") nuclei of neutrophils typical for patients with Pelger-Huet anomaly. In addition to the characteristic two lobes connected by a delicate bridge, the dense, homogeneous nuclear chromatin helps to define Pelger-Huet anomaly. Since the peripheral blood smear did not support the diagnosis of appendicitis in this patient, and since abdominal pain localized to the right lower quadrant never developed, the boy was hydrated with intravenous fluid and observed. After hydration, his constitutional symptoms improved and the abdominal pain subsided. In fact, the lad was back on the ski slopes the next afternoon. People entering high altitude where the humidity may be very low are susceptible to dehydration and may experience symptoms related to mountain sickness. Therefore, close observation and hydration may be the best practice in monitoring patients with stories and findings similar to this one. A further lesson here is that technologists must be alert to the possibility of Pelger-Huet anomaly if a high white blood cell count with a high percentage of band neutrophils with strikingly uniform morphology and without toxic granulation are found. Inappropriate therapy or an invasive procedure as was contemplated here may be avoided by a proper smear assessment and clinical corroboration. | View Page |
| Pelger-Huet Anomaly The Pelger-Huet anomaly is a congenitally acquired condition of nuclear segmentation and is clinically insignificant. There is no loss of cellular function.The condition can be suspected if typical bilobed, "pince-nez" nuclei are observed (left upper frame in the composite photograph).Band neutrophils usually have two distinct lobes, connected by a relatively short but thick bridge as illustrated in the upper and lower right frames. Monolobated cells may also be encountered, as illustrated in the lower left frame. If these are seen in significant numbers, the possibility of a homozygous Pelger-Huet should be considered. | View Page |