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Pathology · Haematology
Sample itemA routine smear from a healthy 30-year-old shows many neutrophils with bilobed, spectacle-like nuclei and coarse clumped chromatin. He has no infections and his neutrophil function is normal. What is the finding?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Pelger-Huet anomaly
Pelger-Huet anomaly is a benign inherited nuclear segmentation defect, with bilobed nuclei and normal function. It must be distinguished from pseudo-Pelger cells of myelodysplasia, which come with cytopenias and other dysplasia.
Option by option
A. Megaloblastic hypersegmentation
Megaloblastic change gives neutrophils with five or more lobes, the opposite of reduced segmentation.
B. May-Hegglin anomaly
May-Hegglin shows giant platelets with thrombocytopenia and Dohle-like inclusions in neutrophils.
C. Chediak-Higashi syndrome
Chediak-Higashi shows giant lysosomal granules and recurrent infections, not a segmentation defect.
D. Pelger-Huet anomaly (correct)
Correct. Bilobed neutrophils with normal function and no illness describe this benign lamin B receptor defect.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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