New York State Department of Health - Wadsworth Center - Cytohematology Proficiency Testing
Slide 067 [100X]
This slide was taken from a 94 year-old female with an intestinal obstruction. There were many banded and segmented neutrophils. The cytoplasm in the cell indicated by the arrow shows toxic granulation and was the main feature of this cell. Several laboratories noted the presence of Döhle bodies. Although this was not the target response for slide 067, they are present. Toxic granulation and Döhle bodies are found in stress states related to infection or inflammation. Both are acceptable answers. "Cellular stimulation, particularly in the younger cells, may cause alteration in the membrane, which in turn causes granules to appear visibly larger and darker." Döhle bodies "are round to oval, are approximately 1-5 m in diameter, and are composed of parallel rows of ribosomal RNA. When stained, they vary in color from gray to light blue. Although no clear mechanism for their production is known, they are associated with a wide range of chemical and physical insults such as burns, infections, surgery, and with pregnancy." 1 Nine laboratories reported band neutrophil. The instructions requested the identification of the cytoplasmic findings, therefore code 08 is not an acceptable response.
1 (Rodak B.F. Diagnostic Hematology. Philadelphia, PA: WB Saunders, p 300, 1995.)
| NUMBER OF RESPONSES | % OF LABORATORIES | CELL CODE AND TYPE |
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Code:20 Toxic granulation |
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Code: 21 Döhle bodies |
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Code:08 Band neutrophil |
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Code:31 Basophilic stippling |
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