Reactive changes in neutrophils, lymphocytes, and monocytes

• Neutrophils

  • Toxic granulations: coarse, purple cytoplasmic granules that are a sign of a bacterial infection

  • Toxic vacuolization: holes in the cytoplasm associated with bacterial sepsis

  • Dohle bodies: little blue lakes of dilated ER

  • All are associated with bacterial infection

• Lymphocytes – transformed variant/atypical lymphocytes

  • See a lot of lymphocytes, but they look different than those of a leukemia because the cells are heterogenous, not homogenous

  • Often associated with viral infection (e.g., EBV), but it’s really only a nonspecific reaction to antigenic stimulation as seen with drug hypersensitivity, TB, fungal infections, and stress

  • If platelets are normal suspect infection; if they’re low it may be a malignancy

• Monocytes – cytoplasmic basophilia and vacuolization

  • Irregular nuclear contours and cytoplasmic vacuoles in a basophilic cytoplasm

  • Lots of cytoplasmic vacuoles

Category: Medical Subject Notes , Pathology Notes