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Green Neutrophilic Inclusion Bodies: a Rare Phenomenon Indicating a More Critical Situation for Patients by Nanjing Cao, Na Li, Hongmei Wu, Mengke Luo, Haili Lv, Jiuju Wang

Background: Green neutrophil inclusion bodies represents a rare and specific cytoplasmic change in neutrophils, which is often accompanied by acute liver failure and lactic acidosis, making them an indicator of poor prognosis and high mortality risk in patients.
Methods: Here, we report a case with green neutrophil cytoplasmic inclusion bodies from the aspects of clinical manifestation, morphological characteristics, identification of similar inclusion bodies, and scatter diagram distribution, along with a literature review.
Results: Green neutrophil cytoplasmic inclusion bodies have a green or blue-green color, variable sizes, and a blocky appearance with ill-defined borders. They are easy to identify and distinguish from similar inclusion bodies and have a characteristic scatter diagram distribution. In addition, their appearance is often accompanied by acute liver failure and lactic acidosis, indicating a very poor prognosis, which is consistent with previous reports.
Conclusion: Green neutrophilic inclusion bodies are a rare phenomenon indicating a more critical situation for patients. A better understanding of this critical condition is needed to provide insights for clinical prevention and treatment.

DOI: 10.7754/Clin.Lab.2021.211146