Primary Hematopoietic and Lymphoid Tissue ›› Bone Marrow ›› Myeloid ›› Granulocytes & Precursors ›› Neutrophilic ›› Normal
Segmented Neutrophil
›Microscopic Features:
- 2-3x larger than a mature RBC
- Low nuclear to cytoplasmic (N/C) 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)
Myeloproliferative disorders (e.g. CML and CNL)
Leukemoid reaction due to other causes (stress, etc.)
Post-GCSF therapy
Infections (especially bacterial)
Myeloproliferative disorders (e.g. CML and CNL)
Leukemoid reaction due to other causes (stress, etc.)
Post-GCSF therapy
›Classic Immunophenotype:
- CD34-
- CD117-
- HLA-DR-
- CD13+
- CD33+
- CD15+
- CD11b+
- CD16+
›Cartoon Image:
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›Misc:
Normal segmentation is 3-5 lobes while Hypersegmentation is >5 lobes