Benign Leukocytoses Flashcards
Types of neutrophilia
Mature
Immature
Mature neutrophilia
Lots of segmented neutrophils
Immature neutrophilia
Lots of immature neutrophils
Causes of mature neutrophilia
- Infection (bacterial)
- Inflammation
- Physiologic things (stress, hormones)
Toxic changes in neutrophilia (can occur in either type)
- Seen only in infection!
- Toxic granulation, Dohle bodies, cytoplasmic vacuolization.
- Scariest: cytoplasmic vacuolization
Dohle bodies
Sky blue pieces in neutrophil cytoplasm. Probably represent RER
Immature neutrophilia causes
Inflammation, infection (bacterial), severe anemia, something filling up the marrow
Cytoplasmic vacuolization
Indication of very severe infections
Forms of immature neutrophilia
- Left shift
- Leukemoid reaction
- Leukoerythroblastic reaction
Leukoerythroblastotic reaction causes
Due to something malignant or due to something benign
Normal immunophenotype in blood
T cells 80%. B cells 15%. NK cells 5%.
Causes of mature lymphocytosis
Infectious lymphocytosis
Bordetella pertussis
Transient stress
Infectious lymphocytosis
Can give a really high mature lymphocyte count
Causes of reactive lymphocytosis
Infectious mononucleosis
Pediatric viral infections
Viral hepatitis
Immune disorders
Best way to differentiate between benign neutrophilia from CML
Cytogenetics (looking for Philadelphia chromosome switch)
Left shift (benign)
- May see toxic changes
- Fewer immature cells
- No basophilia
- LAP normal/increased
CML (malignant)
- Super-high WBC
- Lots of immature cells
- Basophilia
- LAP decreased
Reactive lymphocytosis (benign)
- Atypical lymphocytes
- Young (
Mature lymphocytosis (benign)
- Mature lymphocytes
- Very young (
CLL (malignant)
- Mature lymphocytes
- Monomorphous!
- ALWAYS IN OLDER PATIENTS (>40)
Best way to differentiate benign lymphocytosis from CLL
Immunophenotyping
Basophilia
ONLY IN CML
Causes of Eosinophilia
- Drugs
- Asthma
- Skin diseases
- Parasites
Causes of moncytosis
- Infection
- Malignancy
- Autoimmune disease
