New York State Department of Health - Wadsworth Center - Cytohematology Proficiency Testing

Slide 155 [100X] Click here for a higher resolution image.

The correct response for the arrowed cell is hypersegmentation (Code 18) as correctly identified by 414 participants. Hypersegmented neutrophils are uncommon except in megaloblastic states, sepsis and renal disease. These cells are larger in size compared to the average neutrophil because they have gone through fewer nuclear divisions during their maturation in the bone marrow as a result of the disease.The nucleus consists of six or more distinct lobes and the chromatin is less condensed.

Number of Responses	Percent of Laboratories	Cell Code and Type
414	96.7%	Code 18: Hypersegmentation
13	3.0%	Code 09: Segmented neutrophil
1	0.2%	Code 20: Seg/band neutrophil with toxic granulation