Case History from White Cell and Platelet Disorders: Peripheral Blood Clues to Nonneoplastic Conditions, presented by MediaLab

White Blood Cell Disorders and Platelets:: 4. Intra-cytoplasmic Inclusion Bodies

Case History

A 17-year-old young woman was admitted to the hospital with abdominal pain and a tentative diagnosis of appendicitis.
The total white blood count was 14,500 cells/cumm with a left shift and neutrophils with changes tagged by the arrow in the photographs (see blue arrow).
The bluish-staining, blurred accumulations in the cytoplasm (Doehle bodies), are located at the cell periphery in neutrophils with toxic changes.
Doehle bodies are remnants of endocytoplasmic reticulum and are products of cytokine activity in the induction and shortened activity of neutrophil activation.
They are often present in conditions with increased neutrophil lysosomal activity, manifest as toxic granulation.
In this case, the presence of Doehle bodies serves as markers for infection-induced leukocytosis and supports the diagnosis of acute appendicitis.

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