Pelger-huet Information and Courses from MediaLab, Inc.
These are the MediaLab courses that cover Pelger-huet and links to relevant pages within the course.
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| Seen in infections and inflammations the cell indicated by the arrow in this illustration is exhibiting: | View Page |
| The WBC indicated by the arrow in this illustration is exhibiting: | View Page |
| Identify the object contained in the cell in this illustration indicated by the arrow: | View Page |
| The WBC anomaly indicated by the arrow in this illustration is: | View Page |
| The cell indicated by the arrow in illustration is indicative of: | View Page |
| Pelger-Huet anomaly is characterized by: | View Page |
| Conditions suggested by the macrocytes and the neutrophil in the photograph to the right include: | View Page |
| Which of the following statements are true for hyposegmented neutrophils: | View Page |
| Abnormal granulation can be seen in the cytoplasm leukocytes in which of the following conditions: | View Page |
| Single-Lobed Pelger-Huet Cells This mature neutrophil is showing only one lobe in the nucleus. The chromatin pattern is mature, showing some clumping and some parachromatin. Cell such as these may be seen with inherited or acquired Pelger-Huet. | View Page |
| Degenerate Neutrophils in EDTA blood When examining a slide made from an EDTA tube of normal blood, an occasional cell containing a round pyknotic nucleus and neutrophilic-appearing cytoplasm may be seen. Rare cells such as these do not indicate the presence of Pelger-Huet anomaly. | View Page |
| Pelger-Huet Cells Another nucleus of a neutrophil with a band-shaped nucleus. The chromatin pattern in this cell is more normal in appearance than the chromatin seen in the previous slide, but is still coarse. | View Page |
| Choose ALL of the answers that correctly complete the following statement: Barr bodies are important to recognize because they | View Page |
| Pelger-Huet Anomaly Pelger-Huet anomaly is the inherited form of neutrophilic hyposegmentation. Its transmittance is autosomal dominant and the anomaly is present in one out of 6000 people. When present, all of the neutrophils will be hyposegmented; however, the homozygous state will have increased number of cells with singular round nucleus and decreased numbers of the bilobed forms. | View Page |
| Pelger-Huet Anomaly Does Not Affect Phagocytosis. The main function of neutrophils is phagocytosis. This function is not affected in either the acquired or the inherited anomaly. Since inherited Pelger Huet Anomaly is associated with functionally normal neutrophils, they are considered a nonpathological variant. | View Page |
| Pelger-Huet Cells The band-shaped form seen in the center of this field is typical of the bilobed cells seen in Pelger-Huet. Notice the chromatin structure is almost smooth in appearance, showing little parachromatin. Normal bands have more clumping in the chromatin pattern. | View Page |
| Which of the following are seen in Pelger-Huet anomaly? (Choose ALL of the correct answers) | View Page |
| Normal Band Forms vs. Pelger-Huet Bands Recognition and diagnosis of the inherited form is important because many of these Pelger-Huet neutrophils may be classified as bands, therefore; increased numbers of bands might be erroneously reported in these patients.Since increased bands frequently indicate infection, reporting Pelger-Huet cells as normal band forms could result in inappropriate treatment for infection.Pelger-Huet bands have more coarse chromatin than normal band forms. | View Page |
| A large percentage of the neutrophils on the peripheral blood smear of a young man are similar to those in the photograph.They most likely represent what condition: | 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 |
| The neutrophils seen in two fields in the upper and lower photographs are representative of a majority of the left shift neutrophils found in this peripheral blood smear. The diagnosis of Pelger-Huet anomaly can be made. | 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 |