Benign Leukocytoses Flashcards
Mature neutrophilia
(lots of segmented neutrophils)
Causes of Mature Neutrophilia • Infection (bacterial) • Inflammation • Physiologic things • Stress • Hormones Toxic Changes • Seen only in infection! • Toxic granulation, Döhle bodies, cytoplasmic vacuolization • Scariest: cytoplasmic vacuolization
Immature neutrophilia
(lots of immature neutrophils)
Causes of Immature Neutrophilia • Infection (bacterial) • Inflammation • Severe anemia • Something filling up the marrow
Three Forms of Immature Neutrophilia
• Left shift: more immature neutrophils in the blood
• Leukemoid reaction: looks like leukemia but isn’t. Just ignore this one.
• Leukoerythroblastotic reaction: young leukocytes and young red cells
• Due to something malignant: if hemoglobin isn’t low, its probably malignant
• Due to something benign, if hemoglobin is low, its probably physiologic and benign
Mature Lymphocytosis
Causes of Mature Lymphocytosis
• Infectious lymphocytosis: causes the biggest lymphocytosis!
• Bordetella pertussis
• Transient stress (not important)
Reactive Lymphocytosis
(lots of funny-looking lymphocytes)
Causes of Reactive Lymphocytosis • Infectious mononucleosis • Pediatric viral infections • Viral hepatitis • Immune disorders
Benign vs. Malignant Lymphocytosis
Left shift (benign) • Toxic changes, maybe • Fewer immature cells • No basophilia • LAP normal/increased
CML (malignant) • Super-high WBC • Lots of immature cells • Basophilia • LAP decreased (leukocyte alkaline phosphatase)
The best way to differentiate benign neutrophilia from CML: Cytogenetics.
Know how to differentiate between a benign lymphocytosis and CLL (chronic lymphocytic leukemia).
CLL • Mature lymphocytes • Monomorphous! • Older (>40) The best way to differentiate benign lymphocytosis from CLL: Immunophenotyping.
causes of Basophilia
• CML
causes of Monocytosis
- Infection
- Autoimmune disease
- Malignancy
causes of Eosinophilia
- Drugs
- Asthma
- Skin diseases
- Parasites