Variations in White Cell Morphology -- Granulocytes (retired 9/30/2020) (retired 9/30/2020) (retired 9/30/2020) (retired 9/30/2020) (retired 9/30/2020) (retired 9/30/2020) (by LabCE)

(based on 42 customer ratings)

Authors: Marjorie A. Spahn, MT (ASCP); Barbara Minderman, MT (ASCP)
Reviewers: Rory Huschka, M.Ed., MT(ASCP); Dr. Linda Miller, PhD I, MBCM(ASCP)SI

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

Continuing Education Credits

Course number 20-684362, approved through 9/1/2022


  • 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.
  • Identify and describe the morphological changes associated with Pelger-Huet anomaly, Chediak-Higashi anomaly, Alder-Reilly anomaly, and May-Hegglin anomaly.

Customer Ratings

(based on 42 customer ratings)

Course Outline

  • Introduction
      • Variations in Morphology
      • Importance of Recognition
  • Nuclear Variations
      • Hypersegmentation
      • Conditions Associated with Hypersegmented Neutrophils
      • Hypersegmented Neutrophil versus Normal 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-Reilly Anomaly
      • Alder-Reilly 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) and Barbara Minderman, MT (ASCP).
Reviewer: Rory Huschka, M.Ed., MT(ASCP), has over 25 years of combined experience as a medical technologist, technical supervisor, professor, and manager. He is a former Director of Medical Laboratory Science and Medical Laboratory Technician Programs. He is currently a Program Director at MediaLab, Inc. Rory holds a BS degree in Medical Technology from North Dakota State University and a Masters in Educational Leadership. 
Reviewer: Dr. Linda Miller, PhD I, MBCM(ASCP)SI, is an Assistant Editor for the Immunohematology section of Lab Medicine. She received her BS degree in Biology from Syracuse University and her PhD in Immunology from SUNY Upstate Medical University. She holds certifications as a Technologist in Immunology, Specialist in Immunology, and Technologist in Molecular Biology from the ASCP. Dr. Miller is a professor of Clinical Laboratory Science at Upstate Medical University and the Director of the Medical Biotechnology program in the same department. There, she teaches courses in Immunology, Human Genetics, Molecular Methods, and Medical Biotechnology. She has served as a member of the ASCP Immunology Exam Committee and the ASCP Lab Q Editorial Board as Associate Editor of Clinical Immunology. Dr. Miller has written numerous continuing education exercises and book chapters in clinical immunology and is co-author of the 4th edition of the textbook, Clinical Immunology and Serology: A Laboratory Perspective (FA Davis). 

How to Subscribe
Single online course$20
Add to cart
  • Order for instant access through any computer, any browser.
  • No shipping, faxing, or waiting for certificates.
  • Print or save your certificate of completion as soon as you've completed the course.
  • You'll have 90 days to complete your purchased courses.
Course provided by LabCE.



Alder normal neutrophils arrow

Alder Reilly 2

Auer rod

Barr body

Hyposegmented neutrophil

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