The objective of this paper is to review in what forms sex chromatin can appear in peripheral blood neutrophils and how sex determination can be done using sex chromatin appendages. Sex chromatin is an approximately 1 micron clump of chromatin seen usually at the periphery of female nuclei in certain tissues and called "Barr body" and as a drumstick in polymor phonuclear neutrophils nuclei in the blood smears. Sex chromatin is derived from one of the two X chromosomes in the female which replicates its deoxyribonucleic acid much later than the other and is thus positively heteropyknotic. In 1954, Davidson and Smith were the first to identify and report the presence of neutrophil drumsticks and nonspecific appendages and their differences in sexes. The inactive X chromosome in neutrophils appears in one of the five forms: drumsticks, racquet forms, sessile nodules, small clubs and minor lobes. Only drumstick appendage is sex-specific and considered for sex diagnosis. For sex determination, drumsticks are significantly higher in females than in males (p < 0.001).
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