Variations in White Cell Morphology -- Granulocytes (Online CE Course)

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Authors: Marjorie A. Spahn, MT (ASCP); Barbara Minderman, MT (ASCP)
Reviewers: Rory Huschka, M.Ed., MLS(ASCP) and Patrick Tracy, MA, MLS(ASCP)

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This course covers all aspects of white blood cell morphology, including identifying changes in morphology in granulocytes. Addresses Barr bodies, Dohle bodies, Auer rods, vacuoles, hypersegmented granulocytes, and hyposegmented granulocytes. Excellent as a refresher or for clinical laboratory science students.

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Continuing Education Credits

P.A.C.E.® Contact Hours (acceptable for AMT, ASCP, and state recertification): 2 hour(s)

Approved through 9/30/2024

Florida Board of Clinical Laboratory Personnel Credit Hours - General (Hematology): 2 hour(s)

Approved through 9/30/2024

Objectives

Explain the importance of identifying changes in granulocyte morphology.
Define, describe, and explain the relationship of Barr bodies to abnormal morphology.
Discuss nuclear hypersegmentation and hyposegmentation, with respect to: definition, appearance, composition, and significance.
Discuss nuclear hypersegmentation and hyposegmentation, with respect to: hypersegmented granulocytes and hyposegmented granulocytes.
Identify each of the following cytoplasmic variations: Dohle bodies, Auer rods, vacuoles, and abnormal granulation.
Identify and describe the morphological changes associated with Pelger-Huet anomaly, Chediak-Higashi anomaly, Alder-Reilly anomaly, and May-Hegglin anomaly.

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Course Outline

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Introduction

Variations in Morphology
Importance of Recognition
Match the following:

Nuclear Variations

Hypersegmentation
Conditions Associated with Hypersegmented Neutrophils
Hypersegmented Neutrophil versus Normal Segmented Neutrophil
Which of the following statements is true for hypersegmented neutrophils? (Choose ALL of the correct answers)
Hyposegmentation
Conditions Associated with Hyposegmented Neutrophils
Pelger-Huet Anomaly
Normal Band Forms vs. Pelger-Huet Bands
Bi-lobed Neutrophil
Pelger-Huet Cells
Single-Lobed Pelger-Huet Cells
Which of the following are seen in Pelger-Huet anomaly?
Barr Body
Which of the following best describes a Barr body?
Summary

Cytoplasmic Variations

Döhle Bodies
Döhle Bodies, continued
Toxic Granulation
Toxic Granulation and Vacuolation
Cytoplasmic Vacuolation
Neutrophil with Normal Granulation
Toxic granulation is seen most frequently in:
Auer Rods
Auer Rods, continued
Which of the following inclusions may be seen in the cytoplasm of myeloblasts and promyelocytes?
Auer rods are significant when they are seen in the cytoplasm of blast cells because they are diagnostic for:
Chédiak-Higashi Syndrome
Albinism and Chédiak-Higashi Syndrome
Chédiak-Higashi Syndrome vs. Toxic Granulation
Chediak-Higashi Syndrome Inclusions
Chediak-Higashi Syndrome is characterized by which of the following?
May-Hegglin Anomaly
Alder-Reilly Anomaly
Alder-Reilly Anomaly, continued
Alder-Reilly anomaly inclusions may be found in which of the following white blood cell types?
Which of the following inclusions has a similar appearance on a Wright's stained smear to a Döhle body?
The inclusions that are frequently seen on the same peripheral blood smear with toxic granulation include: (Choose ALL that apply)
What type of inclusions are present in the cell that is indicated by the arrow?
The cell in this image is typical of other neutrophils on this peripheral blood smear from a patient with sepsis. Which morphologic term describes the...
Summary

References

References

Additional Information

Level of instruction: Intermediate

Intended Audience: clinical laboratory science students, medical technologists, and medical laboratory technicians seeking review or continuing education. It is also appropriate for medical students, pathology residents, and pathologists.

Course Description: This course covers morphologic variations observed in granulocytes, including nuclear and cytoplasmic variations.

Authors: by Marjorie A. Spahn, MT (ASCP) and Barbara Minderman, MT (ASCP).

Reviewer: Rory Huschka, M.Ed., MT(ASCP), has over 25 years of combined experience as a medical technologist, technical supervisor, professor, and manager. He is a former Director of Medical Laboratory Science and Medical Laboratory Technician Programs. He is currently a Program Director at MediaLab, Inc. Rory holds a BS degree in Medical Technology from North Dakota State University and a Masters in Educational Leadership.

Reviewer: Patrick Tracy, MA, MLS(ASCP), has been an MLT program director since 2012. His teaching experience has been in student labs, both face to face and online. His contribution to medical-laboratory education is most pronounced by his microbiology, blood bank and chemistry YouTube channel.