Introduction to Leukocyte Disorder Flashcards
Cytosis means?
Condition of increase in cell number
-philia means?
Increase in cell number
-penia means?
Decrease in cell number
What is the formula of absolute count?
Absolute count [cell type] = Differential count [%] X Total WBC count
Define Leukocytosis
Increase in 1 or more normal WBC types in peripheral blood or presence of abnormal cell type(s) in peripheral blood. Usually seen in patients with a total WBC count of greater than 15k / uL in adults
Define Leukopenia
Decrease in neutrophils and/or lymphs. Usually seen in adults with a total WBC count of less than 2500 / uL
Neutrophilia occurs because of 3 major causes…
I.I.M; Infection (bacterial / fungal), Inflammation, and Malignancy
Reactive can mean…?
Term used to describe causes other than malignancy. It can be acute, immediate, or chronic in nature.
Describe Immediate neutropenia
Redistribution from marginating pool to circulating pool - waiting for egression into tissues (pseudoneutrophilia)
Describe Acute neutrophilia
Increase neutrophils from Bone marrow due to infection. This can be seen with an increase in banded neutrophils in blood smears.
Describe chronic neutrophilia
Like acute but stimulus is continuous unless underlying problems are solved. There will be a left shift meaning increase in immature neutrophil (band neutrophil).
Describe pseudoneutrophilia
Benign, transient increase of neutrophil in peripheral blood due to shift of marginating cells into circulating pool. Its caused by release of epinephrine in a stress response.
Pseudoneutropenia
Temporary decrease of neutrophil in peripheral blood due to hypersensitivity reaction, post-hypothermia, post dialysis, and with some tranquilizers. Neutrophil count under 1.5 x 10^9 / L
What is associated with neutropenia due to decrease bone marrow production
Stem cell disorders, megaloblastic conditions, chemical responses, and congenital disorders
What is associated with neutropenia (increased cell loss)?
Immune response and hyperspenism
What are signs of an extreme left shift (Leukoerythroblastic)?
-Presence of nRBCs and neutrophilic left shift
-Variable total neutrophil count
-Poikilocytosis, teardrop cells, and anisocytosis
What conditions/disorders are associated with an extreme left shift?
Myeloproliferative (granulocyte) disorders, myelopthisis, and hemolytic anemias
What is a leukemoid reaction?
Its a transient response to the three I.I.M.; (severe) infection, inflammation, or malignancy.
Elevated WBC count
Presence of banded neutrophils in peripheral blood. Neutrophils will have toxic granulation, dohle bodies, and vacuoles.
-It mimics chronic myeloid leukemia (CML). To differentiate genetic analysis and staining must be done.
Automated analyzers cannot…
Detect neutrophil abnormalities and differentiate nRBC from WBC
Toxic granulation in WBCs are associated with…?
Infection, chemo patients, burns, poisonings, and normal pregnancies.
Describe Toxic granulation
Large, blue-black, altered primary cytoplasmic granules. They lose their color as they mature. They become more visible if there is an infection. If there is no infection then similar patterns (in WBC) are seen as artifacts.
Artifactual toxic versus True toxic granulation
Artifactual granulation will be seen throughout the WBC
True toxic granulation will be seen with dohle bodies, patients with neutrophilia, and left shift.
What are dohle bodies?
Made of RNA remanants from rough ER. They are small gray-blue cytoplasmic inclusions in neutrophils and eosinophils. They will usually be seen with toxic granulation. In older specimens they will appear as gray colored but typically in freshly collected blood.
Describe cytoplasmic vacuolization.
Small vacuoles are signs of autophagocytosis which are associated with drug exposure or radiation.
If vacuoles are large then it is signs of microbe ingestion and degradation which are associated with chemotherapy, infection, poisoning, and burns.
Vacuolization can be observed in old blood too! Double check collection date to be sure if the vacuoles are significant.
What is pyknotic nuclei in segs.
A sign of necrobiosis which is dying nuclei. Associated with sepsis or old blood specimen
Hyposegmentations in neutrophils are associated with…
Pelger-Huet anomaly, myeloproliferative or myelodysplastic disorders
Hypersegmentation in segs
6 or more lobes that are prominent in chronic infection and severe megaloblastic anemia.
