During normal granulocytopoiesis, the lengthening and pinching in of the nucleus are coordinated with progressive condensation of the chromatin and loss of cytoplasmic basophilia. Therefore, normally matured segmented and late band neutrophils, shown in panels A and C, have white cytoplasm with pink granules, long and fairly narrow nuclei and tightly condensed chromatin. The cytoplasmic basophilia can be focal, streaked, or diffuse. Focal basophilia appears as pale blue spots, called Doehle bodies, that represent aggregated ribosomes and whorls of rough endoplasmic reticulum. Additionally, many cells with toxic change are larger than normal and have frothy or vacuolated cytoplasm, which represents degranulation of lysosomes.
Specific granules are less visible than in normally matured cells.
Doehle bodies in otherwise normal segmented neutrophils are not a significant abnormality. The term derives from the fact that these abnormalities were first noticed in human patients with gram negative sepsis and endotoxemia. Toxic change in neutrophils can be associated with inflammation of any cause if severe enough to intensely accelerate neutrophil production.