Neutrophil "Green Crystals of Death"

[SMILLER]

Has anyone else ever noted these?  These crystals appear with Wright-Giemsa stain as greenish aggregates in neutrophils.  They are often associated with severe necotizing liver disease.  Here is one reference but there are others on the net:

https://www.ascls.org/communication/ascls-today/320-ascls-today-volume-32-number-4/431-a-case-of-blue-green-neutrophil-inclusions

In the articles I've looked at, they may only appear in 1-2% of cases, so they are easy to miss.  There are a few good images on the internet if you look for them.  I was wondering if anyone else who is aware of these things, routinely reports them if they are noted.

Thanks, Scott 

[nziegler]

I've heard about them, and we think we may have seen them, but not reported. Curious what people would report them as. I would think that reporting "rare green crystals of death" might be a little disconcerting to the physician!

[Alan Neal]

We have seen these in a number of very 'sick' patients  - most recent case in a Gram Neg sepsis with DIC & 'bugs' in neutrophils!

We do report with following comment - Neutrophils show green inclusions-indicates severe toxic state (& we would alert clinician).