Leucocytes and Pathology Flashcards
When thinking about the types of cells in blood, what must we separate?
Separate the lymphoid series and myeloid series
What does the white cell count look at?
Lymphoid series and granulocytes
Why type of cells are leucocytes?
Nucleated cells
Describe the myeloid/neutrophil maturation in bone marrow?
Myeloblast Premyelocyte Myelocyte Metamyelocyte Band neutrophil/neutrophil
What is the function of neutrophils and where are they found?
Search, ingest and destroy bacteria
Usually occurs in tissues
Rarely seen in the blood
Pro-inflammatory and anti-inflammatory effects
What is neutrophilia?
Increase in the number of neutrophils.
What are causes of neutrophilia?
Infection (e.g. pneumonia, abscesses, tonsillitis, UTI) - left shift to immaturity of neutrophils, toxic changes in severe infection: vacuolation, toxic granulation.
Steroid induced. Prednisone causes demargination.
Chronic mild neutrophilia due to smoking, obesity etc.
What are causes of neutrophilia?
Infection (e.g. pneumonia, abscesses, tonsillitis, UTI) - left shift to immaturity of neutrophils, toxic changes in severe infection: vacuolation, toxic granulation.
Steroid induced. Prednisone causes demargination.
Chronic mild neutrophilia due to smoking, obesity etc.
What are the causes of neutropenia?
Viral infection e.g. glandular fever
Part of a pancytopenia (anaemia, neutropenia, thrombocytopenia e.g. chemo or bone marrow disease)
Drug SE: marrow suppression
Genetic neutropenia - some families, racial
Fulminant bacterial infections
What do we do for mild neutropenia?
Not clinically important
Check rest of blood count and film
What do we do for severe neutropenia?
Watch for fever (give antibiotics if febrile)
Consider protective isolation
Occasionally treat with G-CSF
In severe neutropenia, bacterial infections may be atypical - no pus
List the reasons for acquired functional defects of neutrophils.
Diabetes Alcoholism Renal failure Steroid medication Genetic defects also exist, but are rare
What function do eosinophilia have?
Immune function and homeostasis
What causes eosinophilia?
Parasitic infections Allergic reactions (including drug reactions) (Some auto-immune conditions and rare blood cancers)
What is the function of monocytes?
Become tissue resident macrophages
What causes monocytosis?
Recurrent chronic inflammatory states - chronic bacterial infections e.g. untreated pneumonia, bacterial endocarditis, TB Myelodysplastic syndrome (bone marrow cancer)
What are the functions of basophils?
Immunity against worms
Regulate chronic allergic inflammation
Define a leukoerythroblastic blood film.
Immature white and red cells in the blood
Important sign for severe bone marrow disease
What is leukoerythroblastic anaemia?
Immature cells are pushed out by a full marrow
- Marrow replacement from leukaemia or lymphoma
- Marrow infiltration by metastatic cancer
- Myelofibrosis
Can also occur in severe hypoxia and anaemia
Name the three main types of lymphocytes.
T cells
B cells
Natural killer cells
Name causes for lymphocytosis.
Age dependent Child: viral infection, pertussis, acute lymphoblastic leukaemia Young adult: EBV Any: CMV, toxoplasmosis Elderly: chronic lymphocytic leukaemia
Name some examples of myeloid cancers.
Acute myeloid leukaemia - rapid growth of precursor cells in marrow
Myeloproliferative neoplasms - excessive growth of mature cells in marrow
Myelodysplastic syndrome - production of defective myeloid cells in marrow
Name examples of lymphoid cancers.
Depends on maturity and function of cell type.
Precursor lymphoid neoplasms - acute lymphoblastic leukaemia = rapid proliferation of large precursor cells
Mature lymphoid neoplasms
Reflect the behaviour of the original cell
What is pancytopenia?
Due to bone failure e.g. lymphoma, metastatic cancer
Anaemia, neutropenia, thrombocytopenia
