Green neutrophilic inclusions: current understanding and review of literature.

PURPOSE OF REVIEW: Green cytoplasmic inclusions in neutrophils are an uncommon finding on the peripheral blood smear. A comprehensive review of the literature is presented here with the goal of summarizing knowledge to date and increasing awareness.

RECENT FINDINGS: A total of 41 cases have been reported in the literature, indicating the rarity of these green neutrophilic inclusions. Clinically, the inclusions have most consistently been associated with elevated transaminases, hepatic failure, and a high early mortality rate. The precise composition of the inclusions has not been confirmed.

SUMMARY: Clinicians, hematologists, and laboratory technicians should be educated and have a high level of awareness of green neutrophilic inclusions. A more comprehensive analysis of a larger number of cases will be needed to clarify the true prevalence, associated conditions, biochemical nature, and clinical significance of this unusual finding.