Leukocyte Morphology on Peripheral Smear

Aka: Leukocyte Morphology on Peripheral Smear, Leukocyte Morphology, White blood Cell morphology, Hypersegmented Neutrophil, Bilobed Neutrophil, Atypical lymphocyte, Toxic granulation, Lymphoblast, Plasmablast, Myeloblast, Promyelocyte, Myelocyte

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II. Background

  1. Variants below as seen on Peripheral Smear

III. Causes: Toxic granulation of Neutrophils and Metamyelocytes

  1. Bacterial Infections

IV. Causes: Atypical lymphocytes

  1. Characteristics
    1. Larger Lymphocytes with more cytoplasm
    2. Nuclei contain nucleoli
  2. Causes: Viral Infections
    1. Epstein Barr Virus (EBV, Mononucleosis)
    2. Cytomegalovirus (CMV)
    3. COVID-19
    4. HIV Infection

V. Causes: Giant cytoplasmic granules

  1. Chediak-Higashi Syndrome

VI. Causes: Bilobed Neutrophils

  1. Pelger-Huet anomaly

VII. Causes: Hypersegmented Neutrophils

  1. Pernicious Anemia (Vitamin B12 Deficiency)
  2. Folate Deficiency
  3. Myeloproliferative disease

VIII. Causes: Myeloblasts, Promyelocytes, Myelocytes

  1. Acute Myeloblastic Leukemia
  2. Acute promyelocytic Leukemia
  3. Chronic myelocytic Leukemia
  4. Myelofibrosis
  5. Polycythemia Vera

IX. Causes: Large Granular Lymphocytes

  1. T-gamma lymphoproliferative disease
    1. Natural Killer Cells

X. Causes: Lymphoblasts

  1. Acute Lymphoblastic Leukemia
  2. Prolymphocytic Leukemia
  3. Malignant Lymphoma
  4. Chronic Lymphocytic Leukemia
  5. Infectious Mononucleosis

XI. Plasmablasts

  1. Multiple Myeloma

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