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Lymphoreticular and Haemopoietic > Abnormalities of the Leukon > Flashcards

Abnormalities of the Leukon Flashcards

1
Q

Where are leukocytes produced?

A

Bone marrow - all cell lines
Spleen and liver - maintain potential to produced all leukocyte lines
Thymus, spleen and LNs - differentiation of lymphoid

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2
Q

What makes up total WBC concentration?

A 
Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils
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3
Q

What influences total leukocyte numbers?

A

Dynamic equilibrium
Balance between peripheral demand and ability of bone marrow to supply replacements
Position of leukocyte within blood vessel

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4
Q

How can you identify neutrophils on smear?

A

Segmented nuclei and fine cytoplasmic granules

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5
Q

What are the different neutrophil pools?

A
  1. Proliferation pool
  2. Maturation pool
  3. Storage pool
  4. Circulating pool
  5. Marginating pool
  6. Tissue pool
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6
Q

Describe the maturation of neutrophils

A
  1. Myeloblast
  2. Myelocyte
  3. Metamyelocyte
  4. Band neutrophil
  5. Segmented neutrophil
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7
Q

What pool of neutrophils are you sampling when you sample neutrophils? What is the neutrophil half life in blood?

A

Circulating pool

5-10 hours

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8
Q

What is the circulating:marginated neutrophil ratio like in dogs? What does this mean?

A

Near 1
At any given time up to half are not circulating but in tissue
When adrenaline increases, tissue pool can double back into circulation
Can appear as significant neutrophilia

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9
Q

What is left shift?

A

If demand is high more immature neutrophils are released

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10
Q

Describe the toxic changes to neutrophils…

A

In peripheral blood
Accelerated production
Cytoplasmic foaminess
Dohle bodies, giant neutrophils, vacuolation, toxic granules

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11
Q

Describe degenerative/lytic change to neutrophils…

A

In tissues
Bacterial toxins
If you have septicaemia you may have degenerative neutrophils in the circulation

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12
Q

What is regenerative left shit? What does it indicate?

A

Neutrophilia
Segmented > bands
Big demand but marrow producing lots of neutrophils to cope - this is good.

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13
Q

What is degenerative left shift? What does it indicate?

A

Neutropenia
Bands > segmented
Other than horses, bands > segmented is v rare.
If you have bands but no neutrophils you are in trouble.

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14
Q

What is right shift?

A

> 5 lobes to a neutrophil
Keep segmenting
e.g. steroids down regulate adhesion molecules

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15
Q

What are the different types of neutropenia?

A
  1. Inflammatory neutropenia
  2. Endotoxin neutropenia
  3. Peripheral destruction neutropenia
  4. Granulocytic hypoplasia neutropenia
  5. Infective production neutropenia
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16
Q

What is inflammatory neutropenia?

A

Kicks out storage pool

More into tissue than marrow can produce

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17
Q

What is endotoxaemia neutropenia?

A

Marrow ok

Sudden increase in maturation means they go from circulating to marginating pool

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18
Q

What is peripheral destruction neutropenia?

A

Marrow producing more but being destroyed in the periphery

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19
Q

What is granulocytic hypoplasia neutropenia?

A

Marrow not producing enough

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20
Q

What is ineffective neutropenia?

A

Dysplasia so cells not viable and don’t enter circulation

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21
Q

Describe neutrophilia in terms of increased production and increased demand…

A

Inflammatory neutrophilia - increased marrow production and storage release.

  • Infections - bacterial, viral, protozoal
  • Immune mediated diseases - IMHA, polyarthritis
  • Secondary to neoplasia
  • Haemolysis, haemorrhage, necrosis, thrombosis
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22
Q

Describe neutrophilia in terms of increased production independent of demand…

A

Well differentiated neutrophils transformed: chronic granulocyctic leukaemia
Poorly differentiated transformed: acute myeloid leukaemia

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23
Q

Describe neutrophilia in terms of increased persistence in circulation

A

Stress/steroid response
Hypersegmented
Accompanied by monocytosis and lymphopenia

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24
Q

Describe neutrophilia in term of redistribution…

A

Stress/excitement increased blood pressure
Marginated neutrophils swept into circulation
May increase WBC number up to 200% in cats
Lymphocytes prevented from leaving circulation = number increased

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25
Q

Treatments for neutrophil abnormalities…

A

Treat underlying causes
Chronic granulocytic leukaemia = good short term prognosis
Acute myeloid leukaemia = no successful treatment

26
Q

How can you identify lymphocytes on smear?

A

Large nucleus with small amount of blue cytoplasm

27
Q

How long do B cells last?

How long do T cells last?

A

B cells = days to weeks
Memory B cells = longer lived
T cells = months to years

28
Q

Describe production and circulation of lymphocytes…

A

Formed in bone marrow
Production and clonal proliferation in thymus, spleen and LNs
Recirculate from blood into tissues and lymphatics

29
Q

Describe the reactive changes you may see in lymphocytes…

A

Antigenic stimulation = nucleus becomes larger with a bit more cytoplasm

Strong antigenic stimulation = may pick up plasma cells

30
Q

Describe lymphopenia in terms of increased demand…

A

Some protein losing enteropathies
Chylothorax
Recruitment and emigration into tissue with some antigens

31
Q

Describe lymphopenia in terms of redistribution…

A

Steroid/stress - redistribution to bone marrow, tissues, trapping LNs
Trapping in lymph rich fluid e.g. chylothorax

32
Q

Describe lymphopenia in terms of decreased production…

A

Infectious causes
Lympholytic drugs e.g. chemo
Congenital immunodeficiencies where B and T cells affected

33
Q

Decribe lymphocytosis in terms of increased numbers and increased demand…

A

Persistent antigenic stimulation (funal, protozoal, FeLV, leishmania, brucellosis)
Post vaccination
Young animals

34
Q

Describe lymphocytosis in terms of increased numbers independent of demand..

A

Chronic lymphocytic leukaemia = well differentiated slowly progressing

Acute lymphoblastic leukaemia = more poorly differentiated (poor prognosis)

Stage V lymphoma = bone marrow involvement and release of neoplastic lymphocytes into circulation

35
Q

Describe lymphocytosis in terms of redistribution..

A

Physiological leukocytosis = adrenaline increases, high BP, wash back into circulating pool from marginating pool

Hypoadrenocorticism = no steriods

36
Q

How can you identify monocytes on smear?

A

Largest cell
Neutrophils have darker denser nucleus
Monocyte has blue-grey cytoplasm
Hard to differentiate monocyte and degenerative neutrophils

37
Q

Describe the different pools of monocytes…

A

No storage pool

Do have marginated and circulating pools

38
Q

Describe circulation of monocytes

A

Persistence in circulation varies, shortens with inflammation
Leaves circulation to tissues
Differentiaties in macrophages with inflammatory cytokines

39
Q

Describe monocytosis in terms of increased numbers with increased demand

A

Infectious causes
IMHA, meningitis, polyarthritis
Necrosis, trauma, burns
Neoplasia

40
Q

Describe monocytosis in terms of increased number independent of demand

A

Secondary to immune neutropenia
Myelomonocytic leukaemia - acute and chronic
Acute monocytic leukaemia

41
Q

Describe monocytosis in terms of redistribution

A

Steroids may move them out of marginated pools

42
Q

Treatment for monocytosis?

A

Treat underlying cause

Chronic myelomonocytic much the same as chronic granulocytic leukaemia

43
Q

How can you identify eosinophils on smear?

A

Segmented nucleus
Granules in cytoplasm
Orange granules
Looks like they have vacuoles

44
Q

Species differences in eosinophils?

A

Greyhound = look like very vacuolated neutrophils

Cat = very orange and clear neutrophils

Horse = looks like mulberry

45
Q

How long does it take eosinophils to differentiate and mature?

A

2-6 days

46
Q

Describe circulation of eosinophiles..

A

Random entry into tissues, skin, resp, GI

Directional with chemokines and immatory mediators

47
Q

What can cause eosinopenia?

A

Mechanisms unclear

  • Corticosteroids via apoptosis
  • Catecholamines
48
Q

Describe eosinophilia in terms of increased demand

A

Parasitic antigen
Allergic disease - atophy, drug allergy, asthma, pulmonary infiltrate with eosinophils
Inflammation of mast cell rich tissues (GI, skin, lungs, uterus)

49
Q

How is T cell lymphoma associated with eosinophilia?

A

T cells produce IL-5 which is specific for eosinophils

50
Q

Describe eosinophilia in terms of increased numbers independent of demand…

A

Paraneoplastic (IL5)
Hypereosinophilic syndrome
Eosinophilic leukemia

51
Q

How can you identify basophils on smear?

A

Rarely seen them as so few in circulation
Huge cells
Segmented nucleus that looks like ribbon
Dark purple granules in dog, lilac in cats

52
Q

Describe circulation of basophils

A

Persistent in circulation for 6hrs

Role in type 1 hypersensitivites

53
Q

Describe basophilia in terms of increased numbers due to increased demand…

A

Immediate or delayed hypersensitivies

Parasitism

54
Q

Describe basophilia in terms of increased numbers independent of demand..

A

Paraneoplastic

Basophilic leukaemia

55
Q

What does a stress leukogram look like?

A

Neutrophilia
Lymphopenia
Monocytosis
Eosinopenia

56
Q

What does Addison’s leukogram look like?

A

Reverse stress leukogram
Neutrophils and monocytes usually normal
Lymphocytosis
Eosinophilia

57
Q

What does an acute inflammatory leukogram look like?

A 
Neutrophilia with or without left shift
Lymphopenia
Monocytosis
Eosinopenia
Looks similar to stress leukogram, but wouldn't expect toxic changes and left shift with steroids
58
Q

What does a chronic inflammatory leukogram look like?

A

Neutrophilia with or without left shift
Lymphocytosis
Monocytosis

59
Q

What leukocyte response would you see with adrenaline?

A

Neutrophilia
Lymphocytosis
Looks similar to chronic inflammation. However, adrenaline response very transient - repeat test

60
Q

What does normal haemogram look like for young animals?

A

Higher numbers of WBS
Lower haematocrit
Changes are usually mild - normalised around 3months

Lymphoreticular and Haemopoietic (14 decks)

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