Revisiting Howell-Jolly Body-Like Cytoplasmic Inclusions in Neutrophils: A Report of Two Cases and Confirmation of Nuclear Origin
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Bibliographic record
Abstract
Howell-Jolly body-like inclusions in neutrophils have been reported in a handful of reports; however, their nuclear origin has never been confirmed to date. We report the presence of these cytoplasmic inclusions in two cases and confirm their DNA-based origin by fluorescent nuclear staining. Peripheral blood smears were manually reviewed by light microscopy and after 4',6-diamidino-2-phenylindole (DAPI) fluorescent staining via confocal microscopy. Methanol fixed peripheral blood smears were incubated with DAPI (Sigma Aldrich, St. Loius, MO, USA) and coverslipped with mounting media. DAPI-stained cells were imaged with a Leica SPE confocal microscope using a 405 nm excitation laser and a 63×/1.3 NA oil immersion objective. Optical sections spanning the entire cell thickness were acquired and maximum intensity projections were produced in ImageJ. Both cases described herein had Howell-Jolly body-like inclusions similar to those reported in the literature. Testing for relevant infectious etiologies was negative. Positive staining on fluorescence microscopy confirmed DNA-based origin of this cytoplasmic inclusion material. These DNA-based inclusions occur in the immunosuppressed patient and mimic infectious inclusions. While morphologically worrisome, recognition of these inclusions may prevent unnecessary treatment and testing in clinically appropriate patients.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it