Study of Neutrophil Nuclear Lobulations on Peripheral Blood Smears and Distinguishing the Bilobed Neutrophils From Pelger Huet Cells

Abstract

BACKGROUND Myeloid cells in the peripheral blood are classified into neutrophils, eosinophils and basophils depending on the staining characteristics of the cytoplasmic granules. 1 Neutrophils are lobulated granulocytes. The mature human neutrophil, unlike most other cells exhibits a distinctly non-spherical nucleus, which is segmented into three to five lobes. 2 MATERIALS AND METHODS A prospective study of 1000 Peripheral Blood Smears (PBS) was undertaken. The EDTA venous sample was run on cell counter. NDC was calculated, the data was tabulated and analysed statistically. RESULTS All smears showed bilobed neutrophils. Maximum (89.9%) smears showed 11-30 % bilobed neutrophils in their smears. Classical Pince-Nez nuclear morphology was found in 808 cases (80.8%) (Pince-Nez morphology-two well defined symmetrical lobes connected with thin strand of nuclear material). CONCLUSION The pince-nez morphology is frequent in neutrophils. Detecting rod like, dumb-bell shapes, peanut shaped nuclei are more diagnostic of PHA/PPHA. Important distinguishing features are smooth outline of nuclear lobes and coarseness of chromatin.