Granulocytes in the peripheral blood may show increased number of cytoplasmic vacuoles in response to medications or an inflammatory response. They may also occur as an in vitro degenerative change.
Parameters:
(1) average number of vacuoles per cell in the neutrophilic series (mature segmented cells, bands, other)
(2) percent of cells in the neutrophilic series showing vacuoles
average number of vacuoles per neutrophil =
= (total number of vacuoles for N neutrophils) / (N neutrophils)
percentage of cells with vacuoles =
= (number of cells with vacuoles) / (total number of cells counted) * 100%
Average Number of Vacuoles Per Neutrophilic Cell
Percent of Neutrophilic Cells with Cytoplasmic Vacuoles
Grade
< 1
< 5%
0
1 to 2
< 5%
+/-
2.1 to 4
5 to 25%
1+
4.1 to 7
25.1 to 50%
2+
7.1 to 10
50.1 to 75%
3+
> 10
> 75%
4+
where:
• Having an average of > 10 vacuoles per neutrophil should be a rare event. Having > 75% of neutrophils with vacuoles would be a more common event.
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