Which of the following is true regarding hypersegmented neutrophils?
a. Found in so many conditions that they are not significant
b. Reported when neutrophils have four or more nuclear segments
c. Are an early, consistent, and specific finding in megaloblastic anemia
d. Usually accompany microcytic red cells
ANS: C
Hypersegmented neutrophils are consistently found early in megaloblastic anemia. Because they are not found in any other condition, they are considered specific. Thus they usually accompany macrocytic red cells (including macroovalocytes). Laboratories may use differing criteria for hypersegmentation. However, all would agree that observation of one six-lobed neutrophil is evidence of hypersegmentation. Some will do a neutrophil lobe count, and report hypersegmentation when the average is greater than 3.4.
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