The neutrophils found in Chediak-Higashi must be differentiated from toxic granulation. In conditions causing toxic granulation, the granules are smaller and more numerous, and neutrophils are usually the only cells affected.
In Chediak-Higashi Syndrome, eosinophils, basophils, lymphocytes, and monocytes are affected. Eosinophils may exhibit larger-than-normal eosinophilic granules. Basophils may exhibit larger-than-normal basophilic granules. Lymphocytes may possess large azurophilic granules, while larger pale granules/bodies may appear in monocytes.
The right images show two neutrophils. The top image shows toxic granulation, while the bottom neutrophil is from a Chediak-Higashi patient.
