[1] Along with Döhle bodies and toxic vacuolation, which are two other findings in the cytoplasm of granulocytes, toxic granulation is a peripheral blood film finding suggestive of an inflammatory process.
[1] Toxic granulation is often found in patients with bacterial infection and sepsis,[1][2] although the finding is nonspecific.
[3] Patients being treated with chemotherapy[3] or granulocyte colony stimulating factor, a cytokine drug, may also exhibit toxic granulation.
[2] Toxic granules are mainly composed of peroxidase and acid hydrolase enzymes,[3] and are similar in composition to the primary granules found in immature granulocytic cells like promyelocytes.
[4][5] Although normal, mature neutrophils do contain some primary granules, the granules are difficult to identify by light microscopy because they lose their dark blue colour as the cells mature.