Exam 3 WBC slide set 1 Flashcards
Normal #s for WBCs
4,000 - 10,000/fl
Lymphoid tissue is found in…
- lymph nodes
- thymus
- spleen
- tonsils
- adenoids
- peyer patches
- also lesser in the: BM, lungs, GI & others
2 categories of WBC disorders
Leukocytosis = proliferative
a) reactive - response to microbe
b) neoplastic - less common, more clinically important
Leukopenias = deficiencies
Leukopenia: 2 types & etiology
Neutropenia - decreased neutrophils, most common
Lymphopenia - decreased lymphocytes, less common.
Etiology:
-suppression of myeloid stme cells (aplastic anemia, marrow dz [tumors])
-Defective precursors in bm (megaloblastic anemia, myelodysplastic syndromes)
-congenital (rare inherited conditions - Kostmann syndrome)
-glucocorticoid or drug therapy suppress granulocytic precursors (alkylating agents & antimetabolies in cancer tx suppress BM , Amniopyrine & sulfonamide -> antibodies)
-malnutrition
-some viral infections
-advanced HIV
What is your body doing during leukopenia?
Neutropenia - fewer neutrophils b/c of immune mediated injury (SLE, drugs), splenic sequestration (increased destruction & enlargement of the spleen), or increased peripheral utilization (big infection of bacteria, fungi, or rickettsial pathogens)
Bone marrow - hypercellularity b/c of more precursors b/c of excessive destruction.
-System wide - infections (ulcerating necrotising lesions of gingiva, mouth floor, buccal mucosa, pharynx & less-so in skin, vaginus, anus and GI), **life threatening infix of lung or urinary tract. **Regional lymph nodes enlarged & inflamed.
Leukocytosis
-Increased # of WBCs in peripheral blood.
Toxic Granulation
- Change in cytoplasm of granulocytes, particularly neutrophils, in peripheral smear of its with inflammatory conditions
- Looks like dark, coarse granules
- Common in sepsis
- Finding suggests inflammatory process, along with finding of Dohle bodies & cytosolic vacuolation
- **Thought to be due to impaired cytoplasmic maturation in the effort to rapidly generate large numbers of granulocyes.
Causes of both leukocytosis AND leukopenia
- Increased release from marrow stores (endotoxemia (bacteria), acute infection, hypoxia)
- Decreased margination (more circulating) (exercise, epinephrine)
- Decreased extravasation into tissues (glucocorticoid therapy)
- Increased # of marrow precursors (chronic infection or inflammation, tumors, myeloproliferative disorders)
Non-neoplastic causes of leukocytosis: Neutrophils
- bacterial infxn
- acute inflammation
- necrosis
- *MI
Non-neoplastic causes of leukocytosis: Toxic Granulation
- severe infx
- bacterial sepsis
Non-neoplastic causes of leukocytosis: Eosinophils
- allergy
- parasitic infection
Non-neoplastic causes of leukocytosis: Monocytes
- chronic inflammation (TB, malaria, SLE, RA, IBD)
- mononucleosis
- recovery from acute infxn
Non-neoplastic causes of leukocytosis: Lymphocytes
- acute viral infx (EBV, CMV, viral hepatitis)
- chronic inflammation (TB, etc.)
Non-neoplastic causes of leukocytosis: Bands
-usually a few seen w/infxn (left shift)
Lymphadenitis
- Lymphadenopathy = enlarged lymph nodes
- Acute, nonspecific
- Can be caused by: microbes, cellular debris, or foreign matter introduced into wounds.
- Lymphadenitis can be cervical, axillary, or inguinal.
- *Mesenteric adenitis mimics acute appendicitis
- Enlargement due to cellular infiltration & edema
