| Inclusion | Cabot ring |
| Definition | Toxic granulation is the presence of large purple or dark blue cytoplasmic granules (primary granules) in neutrophils, bands, and metamyelocytes. The granules have increased staining density compared to normal neutrophils |
| Ddx | EDTA storage may produce degenerative vacuolization |
| Conditions associated with the phenotype | Seen in conditions associated with increase cytokine release such as infection, burns, trauma, and G-CSF |
| Mechanism | Toxic changes result from the action of cytokines released in response to infection, burns, trauma, and G-CSF (granulocyte colony stimulating factor) and indicate a shortened maturation time and activation of postmitotic neutrophil precursors owing to decreased transit time in bone marrow |
| Other findings to look for | Often seen with toxic vacuolation, Dohle bodies. Together these three findings are referred to as toxic changes |
| Source/author | William Aird |
| Reviewed and edited by | Parul Bhargava |
