What is the concern if Pelger-Huët anomaly is not recognized?

a. Without treatment, the patient will probably die.
b. The cells could be misclassified as immature neutrophils, indicating that the patient has a bacterial infection when he or she does not.
c. The patient could develop pseudo–Pelger-Huët followed by leukemia.
d. The cells could be misclassified as blasts, indicating that the patient has acute leukemia when he or she does not.

ANS: B
Pelger-Huët cells, because they often have bilobed nuclei, may be mistaken for band neutrophils or metamyelocytes. Those with a round nucleus may be mistakenly reported as myelocytes. This left shift is characteristic of a bacterial infection.