In fact, these features have already been used for decades by pathologists and technologists while reviewing cells under the microscope, and findings such as toxic granulation,
Dohle bodies, and cytoplasmic vacuolization are currently used to raise the suspicion that a patient is undergoing an infectious process regardless of the total and differential leucocyte counts.
Neutrophils revealed toxic changes such as toxic granules, vacuoles, and
Dohle bodies, well-documented changes demonstrated in severe infection or inflammation.
Laboratory investigations showed a leukocyte count of 5.9 cells/L (reference 4.5-11.0 x [10.sup.9] cells/L) (90% neutrophils), with toxic granulation, left shift, and
Dohle bodies on the peripheral blood smear.
The abundant cytoplasmic inclusions in neutrophilic leukocytes (black arrow) morphologically resemble
Dohle bodies, which are frequently found in macrothrombocytopenias, such as May-Hegglin anomaly (1).
Additionally, neutronphils exhibited toxic granulation,
dohle bodies, and vacuolization, all of which indicated the presence of an infection.
Toxic changes such as vacuolisation and the presence of
Dohle bodies occur in infectious diseases and have been associated with high levels of CRP.
Densely basophilic KPCI may be seen in neutrophils along with toxic granulation, non-specific vacuoles, and Dohle bodies. Although the previous reports describe round KPCI, curvilinear forms were also observed in our patient (Figure, B).
In the differential diagnosis, Chediak Higashi inclusions and Dohle bodies should be excluded.
"The previous patient slide had
Dohle bodies, but they were also hard to read.
Medical technologists are able to view a cell class together and/or transport images via their network, which helps to better evaluate hyper-segmented toxic granulation,
dohle bodies, and vacuoles in the neutrophils, thereby reducing technologist time in processing hematology results."
The smear showed 56% band forms, complete with
dohle bodies, vacuoles, and toxic granulation.