Gorup Tina, Cohen Andrea T, Sybenga Amelia B, Rappaport Edward S
Division of Clinical Pathology, Department of Hematology, Scott & White Medical Center - Temple, Temple, Texas.
Department of Pathology, Scott & White Medical Center - Temple, Temple, Texas.
Proc (Bayl Univ Med Cent). 2017 Dec 29;31(1):94-96. doi: 10.1080/08998280.2017.1391045. eCollection 2018 Jan.
Intracytoplasmic green granules in neutrophils have been the subject of conjecture and discussion. Sometimes nicknamed "death cells," these granules are often associated with severe liver disease and have been said to predict acute bad outcomes in severely ill patients. Some recommend that the laboratory community report these granules to treating clinicians as an indication of poor prognosis. We report two patients presenting with secondary liver disease who were found to have blue-green neutrophilic inclusions on the peripheral blood smear. One patient died, while the other patient recovered. We propose that this morphologic finding is likely transient and is related to liver disease and that recovery is possible. Additionally, prognosis in intensive care units continues to be determined by a number of variables, such as age, comorbidities, and severity of illness.
中性粒细胞胞浆内的绿色颗粒一直是推测和讨论的主题。这些颗粒有时被昵称为“死亡细胞”，常与严重肝病相关，据说可预测重症患者的急性不良预后。一些人建议实验室界将这些颗粒报告给治疗临床医生，作为预后不良的指标。我们报告了两名患有继发性肝病的患者，在外周血涂片上发现有蓝绿色嗜中性粒细胞包涵体。一名患者死亡，另一名患者康复。我们认为这一形态学发现可能是短暂的，与肝病有关，且有可能康复。此外，重症监护病房的预后仍由许多变量决定，如年龄、合并症和疾病严重程度。
