Clin Path: Lymphocytosis

Question 1

Name the lymphocytosis that supports the following CBC and Chem findings

Neutrophilia
Erythrocytosis
Thrombocytosis
Hyperglycemia

Answer 1

Physiologic/excitement lymphocytosis

Question 2

What are the 5 main causes of lymphocytosis?

Answer 2

1. physiologic (excitement, epinephrine-induced)
2. Chronic inflammation
3. Young animals
4. Hypoadrenocorticism (Addison’s)
5. Lymphoid neoplasia

Question 3

Name the lymphocytosis consistent with the following CBC and Chem findings

Neutrophilia
Left shift
Toxic change
Monocytosis
Anemia of chronic disease
Hyperglobulinemia

Answer 3

chronic inflammatory lymphocytosis

Question 4

Name the lymphocytosis consistent with following CBC and Chem findings

Mild non-regenerative anemia
decreased MCV
Increased phosphorus
Increased calcium
increased ALP
Increased GGT

Answer 4

pseudolymphocytosis or young age

Question 5

Name the lymphocytosis consistent with the following CBC and Chem findings

Normal neutrophil count
eosinophilia
mild, non-regenerative anemia
hyperglycemia
hyperproteinemia
hypoatremia
hypercalcemia

Answer 5

Hypoadrenocorticisim - Addison’s

Question 6

What are the 3 types of neoplastic lymphocytosis?

Answer 6

lymphoma
acute lymphoblastic leukemia
chronic lymphocytosis leukemia

Question 7

What is the definition of chronic lymphocytic leukemia?

Answer 7

neoplastic proliferation of a clone of a small lymphocytes arising within the bone marrow

Question 8

What is the definition of acute lymphoblastic leukemia?

Answer 8

neoplastic proliferation of immature, large lymphoid cells arising within the bone marrow

Question 9

What is the definition of stage V lymphoma?

Answer 9

neoplastic proliferation of a clone of lymphocytes (usually intermediate to larger) arising outside of the bone marrow (lymph nodes, spleen, thymus, intestine)

Question 10

What neoplastic lymphocytosis is consistent with

Lymphoadenopathy
+/- lymphopenia
+/- blasts in circulation
Numerous types (heterogenous)

Answer 10

lymphoma

Question 11

What neoplastic lymphocytosis is consistent with

blasts >20%
+/- pan/bicytopenia
+/- myelopathies
spleen-hepatomegaly
poor prognosis

Answer 11

acute lymphoblastic leukemia

Question 12

What neoplastic lymphocytosis is consistent with

small lymphocytes
>12k dogs, 20k in cats
tend to live longer

Answer 12

chronic lymphocytic leukemia

Question 13

Compare the length of reactive lymphocytosis vs neoplastic lymphocytosis

Answer 13

reactive is transient
neoplastic is persistent

Question 14

What are the values of lymphocytes in reactive lymphocytosis vs neoplastic lymphocytosis

Answer 14

reactive = cats<20,000, dogs <12,000

neoplastic = >20,000, dogs >12,000

Question 15

Compare the populations of lymphoid cells in reactive lymphocytosis vs neoplastic

Answer 15

reactive - heterogenous
neoplastic - small, monomorphic

Question 16

What additional diagnostics can be used for reactive lymphocytosis? What about neoplastic?

Answer 16

reactive - rickettsial testing, PARR, flow cytometry

neoplastic - bone marrow examination, PARR, flow cytometry

Question 17

What should the results be of PARR testing in reactive vs neoplastic lymphocytosis?

Answer 17

reactive - negative
neoplastic - positive

Question 18

What should the results of flow cytometry be in reactive vs neoplastic lymphocytosis?

Answer 18

reactive - mixed cells
neoplastic - loss of normal cell markers, predominance of one phenotype

Question 19

What are 5 difference causes of lymphopenia?

Answer 19

stress
acute inflammation
depletion
lymphoid hypoplasia
deficiencies in B AND T cells

Question 20

While lymphopenia alone does NOT result from bone marrow injury, if the cause of bone marrow injury also causes _________ then lymphopenia results

Answer 20

damage to secondary lymphoid tissue with lymphoid depletion

Question 21

What can cause lymphoid hypoplasia?

Answer 21

immunosuppressive drugs, radiation, viral destruction, congenital

Question 22

What are 3 causes of acute inflammation?

Answer 22

viral
bacterial
endotoxins