Omar Adwan: Abnormal Nuclear Morphology of Neutrophil
Omar Adwan, Medical Laboratory Technologist at Modawah lab center, 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 Pelger-Huët 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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