Pelger-Huët anomaly - Morphology, mechanism, and significance in the peripheral blood film

Abstract

Take-Home Message: The Pelger-Huët anomaly is a benign dominantly inherited condition. The anomaly takes 2 forms, inherited and acquired. Differentiation depends on the examination of the blood film, clinical disease association, and family history. Pathophysiology: The anomaly is characterized by neutrophil nuclei that fail to segment properly. The pathophysiology is poorly understood. It is considered to be a morphologic alteration comparable to the heterozygous elliptocytosis of the hypochromic-microcytic cells of thalassemia trait. Diagnosis: The differential diagnosis of the anomaly is relatively easy. It is accomplished based on laboratory findings, clinical data, and family history. Morphologically, differentiation focuses on the number or distribution of nuclear lobes, nuclear size, chromatin pattern, and cytoplasmic granulation.