Primary Hematopoietic and Lymphoid Tissue ›› Bone Marrow ›› Normal

Segmented Neutrophil*


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› Microscopic Features:

• 2-3x larger than a mature RBC
• Low nuclear to cytoplasmic ratio (more cytoplasm than nucleus)
• Nucleus is mature and divided into 3 to 5 lobes connected by thin chromatin filaments
• Nucleoli are absent
• More cytoplasm with only secondary granules
• Secondary (specific) granules are neutrophilic (lilac)

› Normal % blood-PB, marrow-BM, lymphoid tissue-LN:

• PB: Most common WBC in blood (~55-70%)
• BM: Scattered (~5-10 %)
• LN: Rare to None

› May Resemble:

• HyperSegmented Neutrophil
• Pseudo-Pelger Huet Neutrophil
• Band Neutrophil
• Neutrophil with toxic granules
• Metamyelocyte
• Myelocyte
• Promyelocyte
• Monocyte

› Differential Diagnoses:

Increased in: Infections (especially bacterial infections) Myeloproliferative disorders (e.g. CML and CNL) Leukemoid reaction due to other causes (e.g. stress) Post-GCSF therapy

› Classic Immunophenotype:

• CD34-
• CD117-
• HLA-DR-
• CD13+
• CD33+
• CD15+
• CD11b+
• CD16+

› Cartoon Image:


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for direct comparison
› Misc:

• Normal segmentation is 3-5 lobes while Hypersegmentation is >5 lobes