Seema Dawood: Abnormal Nuclear Morphology of Neutrophil
Seema Dawood, Medical Laboratory Technologist at The Aga Khan University Hospital, shared a post on LinkedIn:
“Abnormal Nuclear Morphology of Neutrophil
Hyposegmented neutrophils
Neutrophils with nuclei having only 1–2 lobes or appear unsegmented
Unsegmented nucleus:
- Round or oval nucleus with no segmentation
- Bilobed nucleus: Two-lobed nucleus, often resembling pince-nez glasses
Commonly found in:
- Pelger-Huët Anomaly (PHA) – Congenital
- Pseudo PelgerHuët Anomaly (PPHA) – Acquired (associated with bone marrow disorders , severe infections , drug-induced or certain types of leukemia)
Hypersegmented neutrophils
Neutrophils with nuclei having more than 5 lobes (especially more than 6).
The nuclear segmentation is excessive but orderly.
Commonly seen in:
- Megaloblastic Anemia (e.g., Vitamin B12 or Folate deficiency)
- Myelodysplastic Syndromes
- Chemotherapy induced bone marrow suppression
Botryoid neutrophils
Neutrophils with multiple nuclear lobes arranged in a radial pattern, often connected by interchromatin bridges.
The nuclei resemble a ‘grape-like cluster’ (botryoid means grape-like).
Commonly observed in:
- Hyperthermia
- Heatstroke
- Severe bacterial infections
- Extensive burns
- Severe inflammatory responses
- Uremia (kidney failure)
- Chemotherapy or drug toxicity
- May also be observed in hematologic malignancies such as leukemia or myelodysplastic syndrome (MDS)
The presence of Botryoid Neutrophils is considered a warning sign that ‘the body is experiencing a serious pathological condition or critical systemic stress, particularly involving the immune system, severe infections, toxic states, or hematologic disorders.'”
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