Variations in White Cell Morphology -- Granulocytes (by LabCE)

2 P.A.C.E. contact hour(s)

(based on 1,724 customer ratings)

Authors: Marjorie A. Spahn, MT (ASCP); Barbara Minderman, MT (ASCP)
Reviewer: Leah Coppolino, MPH, CLS(NCA), MT(ASCP)

Course provided by LabCE.

This course covers all aspects of white blood cell morphology, including identifying changes in morphology in granulocytes. Addresses barr bodies, Dohle bodies, Auer rods, vacuoles, hypersegmented granulocytes, and hyposegmented granulocytes. Excellent as a refresher or for clinical laboratory science students.

See more courses in: Hematology

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Continuing Education Credits

P.A.C.E.® Contact Hours (acceptable for AMT, ASCP, and state recertification): 2 hour(s)
Course number 578-086-16, approved through 11/30/2018
Course number 20-581268, approved through 9/1/2020


  • Explain the importance of identifying changes in granulocyte morphology.
  • Define, describe, and explain the relationship of Barr bodies to abnormal morphology.
  • Discuss nuclear hypersegmentation and hyposegmentation, with respect to: definition, appearance, composition, and significance.
  • Discuss nuclear hypersegmentation and hyposegmentation, with respect to: hypersegmented granulocytes and hyposegmented granulocytes.
  • Identify each of the following cytoplasmic variations: Dohle bodies, Auer rods, vacuoles, and abnormal granulation.

Customer Ratings

(based on 1,724 customer ratings)

Course Outline

  • Introduction
      • Variations in Morphology
      • Importance of Recognition
  • Nuclear Variations
      • Hypersegmentation
      • Conditions Associated with Hypersegmented Neutrophils
      • Hypersegmented Neutrophils
      • Hypersegmented Neutrophils (cont.)
      • A Normally Segmented Neutrophil
      • Hyposegmentation
      • Conditions Associated with Hyposegmented Neutrophils
      • Pelger-Huet Anomaly
      • Normal Band Forms vs. Pelger-Huet Bands
      • Bilobed Neutrophil
      • Pelger-Huet Cells
      • Single-Lobed Pelger-Huet Cells
      • Barr Body
  • Cytoplasmic Variations
      • Döhle Bodies
      • Döhle Bodies, continued
      • Toxic Granulation
      • Toxic Granulation and Vacuolation
      • Cytoplasmic Vacuolation
      • Neutrophil with Normal Granulation
      • Auer Rods
      • Auer Rods, continued
      • Chediak-Higashi Anomaly
      • Albinism and Chediak-Higashi Anomaly
      • Chediak-Higashi Anomaly vs. Toxic Granulation
      • Chediak-Higashi Anomaly Inclusions
      • May-Hegglin Anomaly
      • Alder Anomaly (Alder-Reilly Anomaly )
      • Alder Anomaly, continued
  • References
      • References

Additional Information

Level of instruction: Intermediate

Intended Audience: clinical laboratory science students, medical technologists, and medical laboratory technicians seeking review or continuing education. It is also appropriate for medical students, pathology residents, and pathologists.

Course Description: This course covers morphologic variations observed in granulocytes, including nuclear and cytoplasmic variations.

Authors: by Marjorie A. Spahn, MT (ASCP); Barbara Minderman, MT (ASCP), updated by EMHP, and adapted for the web by Paul Fekete, M.D. C.A.P AP/CP.
Reviewer: Leah Coppolino, MPH, CLS(NCA), MT(ASCP) is the Director of the Clinical Laboratory Science Program at St. Christopher’s Hospital for Children in Philadelphia, Pennsylvania. She holds a Masters in Public Health from Thomas Jefferson University.

About the Course: This course is part of a series of courses adapted for the web by MediaLab, under license from Education Materials for Health Professionals, Inc. Dayton OH, 45420. Copyright EMHP. This course was reviewed and revised in 2012.

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Course provided by LabCE.



Barr Body neutrophil

Alder-Reilly lymphocyte




ASCLS CE's design and platform are provided by MediaLab, Inc.