APIH243885242 - CME/CMLE - Blood Cell ID #2 - Peripheral Blood Cells in a Patient with Eosinophilia-APIH243885242

APIH243885242 - Educational Activity

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This educational commentary, authored by Karen A. Brown from the University of Utah, discusses peripheral blood morphology in a 34-year-old female patient presenting with eosinophilia. The patient’s complete blood count (CBC) was normal overall, but showed an increased number of eosinophils.<br /><br />Eosinophils are medium-sized granulocytes characterized by two-lobed nuclei with dense, clumped chromatin and abundant large, uniform, bright red-orange cytoplasmic granules, historically likened to “copper pennies.” Neutrophils, also granulocytes, are similar in size but have nuclei with two to five segments connected by thin chromatin threads and smaller pink or violet granules. Monocytes, the largest leukocytes normally seen in blood, have kidney-shaped or lobulated nuclei with minimal chromatin clumping and abundant blue-gray cytoplasm that may include fine azurophilic granules and vacuoles.<br /><br />Red blood cells (RBCs) in the patient were normocytic, normochromic, and morphologically normal. RBCs typically appear round with a biconcave shape, which gives a central pallor about one-third the cell diameter. RBC size correlates well with the mean corpuscular volume (MCV), which in this patient was 91.1 fL (normal range 80–100 fL). The mean corpuscular hemoglobin (MCH) was 30 pg, indicating normal hemoglobin content, and RBCs were evenly distributed without inclusions.<br /><br />Eosinophilia reflects an increased eosinophil count, which is commonly associated with parasitic infections, allergic reactions, skin disorders, and certain malignancies such as chronic myelogenous and eosinophilic leukemias. Typically, eosinophils remain morphologically normal even when elevated in benign conditions.<br /><br />In summary, normal-appearing leukocytes and erythrocytes were identified, but the increased eosinophil count is an abnormal finding that warrants clinical correlation. Thorough peripheral blood smear review aids in diagnosing underlying conditions linked to eosinophilia.

Keywords

Peripheral blood morphology

Eosinophilia

Eosinophils

Complete blood count

Granulocytes

Red blood cells

Mean corpuscular volume

Leukocytes

Parasitic infections

Chronic myelogenous leukemia