Changes in the morphology of leukocytes
In severe infections in granulocytes of blood, there are toxogenous granularity, vacuolization of cytoplasm and Knyazkova-Dele bodies, which has a serious prognostic significance. The presence of one or more of the above changes indicates the development of bacteremia and generalization of the infection.
The toxicogenic granularity of neutrophils is a coarse, dark red granularity that appears as a result of physico-chemical changes in the cytoplasm under the influence of an infectious agent. It is believed that toxogenous granularity either reflects a violation of the maturation processes of neutrophils, as a result of which coarse granularity is retained in mature cells, or is the result of the absorption of toxic substances. These changes in leukocytes are possible with purulent-septic diseases( often appear before the nuclear shift and is an unfavorable prognostic sign), croupous pneumonia( in the period of resorption of the inflammatory infiltrate the granularity is especially rough), scarlet fever, decay of tumor tissues after radiation therapy.
Vacuolation of the cytoplasm is detected less frequently than toxogenous granularity, but it has no less diagnostic significance. These changes in leukocytes can be detected with sepsis( especially caused by anaerobic infection), abscesses, and acute liver dystrophy.
Taurus Knyazkova-Dele - large white-blue areas of cytoplasm of various forms, free from specific granules. These changes in leukocytes can be detected in inflammatory diseases, infections( measles, scarlet fever), sepsis, burns.
Hypersegmentation of neutrophil nuclei - the presence of more than 5 segments in the nuclei of neutrophils. These changes in leukocytes may reflect a hereditary constitutional feature, as well as a deficiency of vitamin B12 and folic acid. Congenital hypersegmentation is not accompanied by any clinical symptoms.
Pelgerian leukocyte anomaly is a dominant heritable disorder of granulocyte maturation, characterized by a decrease in the segmentation of neutrophil nuclei. Most often, mature neutrophils contain a two-segment or non-segmented nucleus, rarely a three-segment nucleus. By their physiological properties, such cells do not differ from normal, mature neutrophils.
Pseudopelgerian anomaly - a decrease in the segmentation of granulocyte nuclei - is possible with myeloproliferative diseases, agranulocytosis, multiple myeloma, tuberculosis. It is temporary, transient. On recovery of the patient, pseudopelgerian leukocytes disappear. At the heart of the anomaly of maturation of nuclei is a violation of the metabolism of nucleic acids.
Leukolysis cells( the shadow of Botkin-Humprecht) - dilapidated nuclei of lymphocytes with the remains of nucleoli - are found in chronic lim-folicosis.