Benign Leukocytosis Flashcards
Under normal conditions, where are most neutrophils located?
most in the bone marrow - only 5% in the blood
What are the two types of benign neutrophilia?
mature and immature
What’s increased in mature neutrophilia?
you have lots of segmented neutrophils
What’s the most common cause of mature neutrophilia?
bacterial infections (but also general inflammation, stress or hormonal issues)
What are some of the toxic changes you can see in mature neutrophilia with infection?
toxic granulation, Dohle bodies, and cytoplasmic vacuolization
What’s increased in immature neutrophilia?
non-segmented (banded) (immature) neutrophils
What are the potential causes of immature neutrophilia?
bacterial infection, inflammation, severe anemia, something filling up the marrow and kicking them out - like metastatic cancer
What are the three forms of immature neutrophilia?
- left shift
- leukemoid reaction
- leukoerythroblastic reaction
What does left shift mean?
it’s when there’s more immature neutrophils in the blood
What’s a leukemoid reaction?
a reaction in the blood that looks like leukemia but isn’t
What’s a leukoerythroblastic reaction?
it’s where you have both young PMNs and RBCs in the blood (can be due to malignancy or benign issues)
What are the two types of lymphocytosis? How do they differ?
mature (just lot of mature lymphocytes - clumped regions in nucleus) and reactive (lots of funny looking lymphocytes)
What are some causes of mature lymphocytosis?
infectious lymphocytosis (this is the one that causes the biggest increase)
bordetella pertussis
transient stress
What are some causes of reactive lymphocytosis?
infectious mononucleosis, pediatric viral infections, viral hepatitis, immune disorders
How do you differentiate between benign neutrphilia and CML?
Best way is CYTOGENICS
benign left shift: toxic changes, fewer immature cells, no basophilia, LAP normal or increased
CML: super-high WBC, lots of immature cells, basophilia, LAP decrease
