Neutrophilic blood picture means an increased proportion or absolute count of neutrophils in peripheral blood, usually associated with acute bacterial infection, acute inflammation, tissue necrosis, stress, or corticosteroid effect.

On an H&E-stained blood smear, a typical mature neutrophil appears as:

In neutrophilia, the smear shows many such segmented neutrophils. If the response is marked, there may be a left shift, with increased band forms, which have a curved horseshoe-shaped, non-segmented nucleus. Toxic change may include coarse cytoplasmic granulation, Döhle bodies, and cytoplasmic vacuoles.

Note: Peripheral blood films are normally assessed with Romanowsky-type stains, such as Leishman, Wright, or Giemsa, rather than H&E. These stains show neutrophil granules and nuclear detail more clearly. A normal neutrophil makes up roughly 60%-65% of circulating leukocytes.

Eosinophilia on H&E shows an increased number of eosinophils. Each eosinophil has:

For routine peripheral-blood morphology, Leishman, Wright, or Giemsa stain is preferred over H&E because it shows eosinophil granules more distinctly. H&E is mainly used for tissue sections, where eosinophils appear as cells with vivid pink cytoplasmic granules within an inflammatory infiltrate. The characteristic bilobed nucleus and large red-staining granules are described in this eosinophil morphology review.