The neutrophils found in Chediak-Higashi must be differentiated from toxic granulation. In conditions causing toxic granulation, the granules are smaller and more numerous. In toxic granulation, neutrophils are usually the only cells affected.
In Chediak-Higashi anomaly, eosinophils, basophils, lymphocytes and monocytes are affected. In eosinophils, larger than normal eosinophilic granules may be seen. Basophils may exhibit larger than normal basophilic granules. Lymphocytes may possess large azurophilic granules while larger pale granules/bodies may appear in monocytes.
The images to the right show two neutrophils. The top image is that of toxic granulation while the bottom neutrophil is one from a Chediak-Higashi patient.
