| All of the following statements concerning Dohle bodies are true EXCEPT: | View Page |
| A patient has a WBC count of 4,000/mm3, platelet estimation is 3 bizarre platelets/oil immersion field, hemoglobin, hematocrit, red cell count and indice values are within normal limits. Blue staining inclusions are seen in the cytoplasm of many neutrophils. These inclusions fit the description of: | View Page |
| Dohle Bodies Dohle bodies are small blue irregular staining patches of cytoplasm seen near the edge of the cell in granulocytes under certain conditions. Electron microscopic examination reveals that they are composed of aggregates of rough endoplasmic reticulum remaining from an earlier stage of development. | View Page |
| Unusually Darkly Staining Dohle Bodies Unusually dark staining Dohle bodies are seen in the cytoplasm of this cell, along with bacteria, an infrequent finding. The bacteria are round and stain almost black. The Dohle bodies are patches of dark blue stained material. | View Page |
| Dohle Bodies and Toxic Granulation Dohle bodies are frequently seen in conditions such as infection or burns when toxic granulation is also present. The cell in this slide has two Dohle bodies as well as toxic granulation. Vacuoles, although not present in this cell, can frequently appear in a cell containing toxic granulation and Dohle bodies. | View Page |
| The inclusions that can be of diagnostic significance when seen in the cytoplasm of myeloblasts are: | View Page |
| Match each of the following. Answers may be used more than once or not at all. | View Page |
| Chediak-Higashi is characterized by: | View Page |
| Alder-Reilly is characterized by: | View Page |
| Which morphologic term describes this slide? | View Page |
| Which morphologic term describes this slide? | View Page |
| Which morphologic term describes this slide? | View Page |
| More on Dohle Bodies Dohle bodies are seen in a number of conditions, including infections, burns, measles, leukemia and chemotherapy. Dohle bodies are classified as pathological in the sense that they are only present when the body is responding to an unusually severe stress or stimulus. This severe stress may cause the cytoplasm of some cells to mature improperly. Their presence does not aid in the diagnosis of the disorders in which they are found, but they are frequently seen along with toxic granulation and/or vacuoles often present in infections and burns. Recognition is important because their appearance is similar to May-Hegglin bodies, which appear in a rare hereditary disorder called May-Hegglin anomaly. | View Page |
| More on May-Hegglin May-Hegglin bodies stain blue and appear to have a more definite shape than Dohle bodies. When examined under electron microscopy, they appear to be aggregates of thread-like structures in a crystal-like arrangement. May-Hegglin inclusions are RNA material believed to be derived from the endoplasmic reticulum.
May-Hegglin bodies can be seen in monocytes and platelets as well as in all mature granulocytes.
The platelets in May-Hegglin anomaly are very bizarre in appearance and thrombocytopenia is usually noted.
When examining a slide that has bizarre platelets and blue-appearing bodies in the cytoplasm, thought should be given to the possibility of the May-Hegglin anomaly. | View Page |
| May-Hegglin Bodies May-Hegglin anomaly is an autosomal dominant condition characterized by the presence of pale blue inclusions in neutrophils, giant platelets, and sometimes thrombocytopenia.
Inclusions can also occur in eosinophils, basophils, and monocytes.
May-Hegglin inclusions resemble Dohle bodies but are larger and more prominent.
Acquired forms of this anomaly may also occur as a result of the use of cytotoxic drugs. May-Hegglin bodies seen under these circumstances are considered pathological. | 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 |
| Which morphologic term describes this slide? | View Page |
| Dohle Body Dohle bodies are sometimes faintly stained, irregular in shape and are therefore easy to miss when examining a slide. The Dohle body in this cell can be seen near the edge of the cytoplasm. Notice that the cytoplasmic granules are somewhat heavier and darker than normal. | View Page |
| The inclusions that are frequently seen on the same slide with toxic granulation include: (Choose ALL of the correct answers) | View Page |
| Which morphologic term describes this slide? | View Page |
| Which morphologic term describes this slide? | View Page |