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Along with Döhle bodies and toxic vacuolation, which are two other findings in the cytoplasm of granulocytes, toxic granulation is a peripheral blood film finding suggestive of an inflammatory process. [1] Toxic granulation is often found in patients with bacterial infection and sepsis, [1] [2] although the finding is nonspecific. [3]
Basophilic stippling, also known as punctate basophilia, is the presence of numerous basophilic granules that are dispersed through the cytoplasm of erythrocytes in a peripheral blood smear. They can be demonstrated to be RNA .
If there are many neutrophils in the bloodstream containing Döhle bodies, these can be referred to as toxic neutrophils. Toxic neutrophils can also correspond to neutrophils that possess a more basophilic cytoplasm, basophilic granulation (infrequently observed), or cytoplasmic vacuoles in addition to one of the preceding cytoplasmic changes.
Howell was the first to describe these blood cells as being of the prototype stippling, which meant granular degeneration of the red blood cells. [7] In 1893, Max Askanazy, who was studying the blood of an anemic patient, discovered granulation in the blood cells that were polychromatic. Later studies were done by other scientists also showed ...
Toxic vacuolation is associated with sepsis, particularly when accompanied by toxic granulation. [4] The finding is also associated with bacterial infection, [3] alcohol toxicity, liver failure, [4] and treatment with granulocyte colony-stimulating factor, a cytokine drug used to increase the absolute neutrophil count in patients with neutropenia.
Qualitative abnormalities of white blood cells, like toxic granulation, are also visible on the blood smear. Modern complete blood count analyzers can provide an automated white blood cell differential, but they have a limited ability to differentiate immature and abnormal cells, so manual examination of the blood smear is frequently indicated.
the cytoplasm is often abundant and can be basophilic – most often, the cytoplasm is gray, pale blue, or deep blue in color; vacuoles and/or azurophilic granules are also sometimes present; histochemistry shows increased concentrations of acid phosphatase, phosphorylase, and non-specific esterase; prominent clusters and rosettes of free ribosome;
The name comes from the fact that these leukocytes are basophilic, i.e., they are susceptible to staining by basic dyes, as shown in the picture. Structure.