Neutrophil Vacuoles

By William Aird

Two vacuolated neutrophils (arrows) in a peripheral smear from an 87-year-old man with sepsis. Note that each cell contains multiple vacuoles; P, polychromatophilic red cell, B burr cell  (100x, oil).

Single vacuolated neutrophil (arrow) in a peripheral smear from an 87-year-old man with sepsis (100x, oil).
White blood cell, inclusionNeutrophil vacuole
DefinitionRound clear space within the cytoplasm of neutrophils
DdxEDTA storage may produce degenerative vacuolization; vacuoles typically few in number and not associated with toxic granulation or Döhle bodies.
Conditions associated with the inclusionSeen in conditions associated with increase cytokine release such as infection, burns, trauma, and G-CSF.
Mechanism of formationArise from phagocytic activity, which is stimulated by the release of cytokines in response to inflammation or tissue injury.
Other findings to look forVacuoles alone do not constitute toxic change, but when seen in association with toxic granulation and/or Döhle bodies are a feature of toxic change.
Source/authorWilliam Aird
Reviewed and reviewed byParul Bhargava