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Neutrophil granulation (NEUT-SSC*)

The 90 degree side-scattered light (SSC) of the WBC differential channel provides information about cell density or complexity, which represents the granularity of the cells. Neutrophils and eosinophils exhibit the highest SSC of all normal cell populations, especially when compared to mononuclear cells. The parameter NEUT-SSC is a measure of the granularity of the neutrophil population. Hypogranular neutrophils have a low NEUT-SSC value whereas a high NEUT-SSC value is indicative of hypergranularity.

Hypogranularity, identified by a reduced NEUT-SSC value, is a feature of neutrophil dysplasia, which is commonly observed in myelodysplastic syndromes (MDS). The automated detection of hypogranular neutrophils is of great diagnostic value in differentiating between MDS and reactive and benign idiopathic and hereditary causes of neutrophilia. Benign conditions can be ruled out if dysplasia is present, and therefore a neutrophilia in conjunction with a low NEUT-SSC value would suggest an underlying myeloproliferative disorder. Myeloproliferative disorders that show a dysplasia include chronic myelomonocytic leukaemia (CMML) and atypical chronic myeloid leukaemia (aCML). These two conditions can be distinguished by considering the relative prominence of monocytes in relation to neutrophils, as well as immature granulocytes (IG).

Figure: the SSC signal of the neutrophil population, which is plotted on the x-axis of the scattergram, is an indication of the granularity and internal structure of the cells. Fluorescence intensity, which corresponds to RNA/DNA cell content, is plotted on the y-axis.

  *The NEUT-SSC is a research parameter from the WDF channel on XN-Series analysers. In X-Class analysers the parameter is named NEUT-X. Research parameters should not be used for in vitro diagnostics.

 

 

Immature Granulocyte
(IG) count

Immature Platelet Fraction
(IPF)

Nucleated red blood cells
(NRBC)

Reticulocyte haemoglobin
equivalent

Microcytic and macrocytic
red blood cells
(%MicroR, %MacroR)

Hypochromic and hyperchromic
red blood cells
(%HYPO-He, %HYPER-He)

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