Leukocytes Flashcards
Genesis of myelocytes
(Review)
Concentration of basophils
0.4%
Where a small portion of WBCs are found
Peripheral blood
Concentration of lymphocytes
30%
Other term for leukocytes
White blood cells
Formed elements
Platelets
Leukocytes
Erythrocytes
Percentage of neutrophils
50-70%
Where precursor cells are usually found
Bone marrow
Granulocytes
Neutrophil
Eosinophil
Basophil
Percentage of basophils
0.5-1%
Phagocytes
Neutrophil
Eosinophil
Basophil
Monocyte (macrophage)
3 compartments/locations
Bone marrow
Peripheral blood
Tissues
Concentration of monocytes
5.3%
Percentage of eosinophils
2-4%
Sixth type of leukocyte
Plasma cell
Based on presence of granules in cytoplasm
Granulocytes
Agranulocytes
Percentage of lymphocytes
25-45%
Percentage of monocytes
3-8%
Based on function
Phagocytes
Immunocytes
Where main function of WBCs ensues
Tissues
Concentration of eosinophils
2.3%
Functions of WBCs
1 Soldiers against infectious and toxic agents
2 Provide rapid and potent defense against any invader recognized as foreign
3 Play a role in innate and adaptive immunity
Leukocyte classification
Presence of granules in cytoplasm
Number of nuclei
Function
Based on number of nuclei
Polymorphonuclear
Mononuclear
Immunocytes
Lymphocytes (T dell, B cell, NK cell)
Mononuclear
Monocyte
Lymphocyte
Polymorphonuclear
Neutrophil
Eosinophil
Basophil
Stain used in WBC identification
Wright’s stain
Other term for primary granules
Azurophilic
Concentration of neutrophils
62%
Cytoplasmic characteristics
1 Color of the background
2 Presence or absence of granules
3 Color and size of granules
CBC measurements
WBC in thousands/mm3
Differential leukocyte count
Example of a leukocyte with high nucleus-cytoplasm ratio
Lymphocyte
Produce antibody and act in activities of the immune response
Immunocytes
Engulf and destroy
Phagocytes
Formed in thymus and other lymph tissues
Lymphocytes
Plasma cells
Non-granulocytes
Monocyte
Lymphocyte
Plasma cell
Leukocyte formation figure
(Review)
Routine method for identification of WBCs
Peripheral blood smear
Minimal affinity for acidic or basic dyes
Neutrophils
Reaction with methylene blue
Basophil
Nuclear characteristics
1 Shape
2 Color
3 Chromatin pattern
4 Presence or absence of nucleoli
Neutrophils move through tissue spaces by
Amoeboid motion
Indicates if leukocyte is mature or not
Nucleoli
Come from a common myeloid progenitor cell that is also the precursor of RBCs and platelets
Granulocytes
Life of granulocytes after release from bone marrow
4-8 hours
Macrophages destroy them after they have served their purpose
Granulocytes
Low nucleus-cytoplasm ratio interpretation
Nucleus is small in relation to the volume of the cytoplasm
Degrades glycopeptides and carbohydrate cell walls of bacteria
Lysozyme
Nucleus has 2 to 5 lobes joined by a solid filament
Neutrophil
Reaction with eosin
Eosinophil
Criteria for leukocyte identification
1 Cell size
2 Nucleus-Cytoplasm Ratio
3 Cytoplasmic characteristics
4 Nuclear characteristics
Neutrophil forms released in the bloodstream
Band cell
Segmented neutrophil
T or F. Neutrophils take one week to mature before they are released from the bone marrow.
T
Aid in killing bacteria
Granules
Granule content of basophils
1 Histamine 2 Sulphated mucopolysaccharides (mostly chondroitin sulfate; to digest bacterial cell wall) 3 Peroxidase 4 Chymase 5 Tryptase 6 Charcot-leyden crystal protein 7 Platelet-activating factor (PAF) 8 Eosinophil chemotactic factor of anaphylaxis (ECF-A)
Toxic forms of oxygen in lysosomes
Peroxidase
Superoxides
Contents of primary granules
1 Myeloperoxidase 2 Proteases (Elastase and Cathepsin G) 3 Lysozyme 4 Inactive forms of acid hydrolases 5 Bactericidal cationic protein
Neutrophils enter tissue spaces by
Diapedesis
Formed in bone marrow
Granulocytes
Monocytes
Few lymphocytes
Life of granulocytes in tissues
A couple of days
Function of neutrophils
Mediate immune response against infectious agents and organisms by attacking and destroying bacteria in the circulating blood
Neutrophils engulf offending agents by
Phagocytosis
Characteristics of a segmented neutrophil nucleus
1 2-5 lobes
2 Connected by a filament
3 Condensed nuclear chromatin
4 Pale cytoplasm with specific granules
Examples of leukocytes with low nucleus-cytoplasm ratio
Mature monocytes
Neutrophils
Contents of secondary granules
1 Lactoferrin
2 Lysozyme
3 Collagenases
4 Vitamin B12 binding proteins
High nucleus-cytoplasm ratio interpretation
Nucleus occupies most of the cell area with only a small rim of cytoplasm
Produce numerous regulatory cytokines
Eosinophils
Responsible for killing phagocytosed bacteria
Myeloperoxidase
Contents of quaternary granules
Secretory vesicles
Lymphocyte functions
1 Play a major role in the maintenance of health
2 Antigen recognition and generation of appropriate immune response
What will happen if continuous neutrophil production stops?
Death by sepsis
Presence of few primary granules and abundant secondary granules
Band
May contain Auer rods
Myeloblast
First post-mitotic myeloid precursor
Metamyelocyte
Neutrophils are attracted to inflamed areas by
Chemotaxis
Presence of rare primary and many secondary granules
Metamyelocyte
Cell-mediated immune response
T/NK cells
Life span of neutrophils in peripheral blood
7 hours
Seen in times of stress
Metamyelocyte
Granules formed in myelocytes
Secondary
Life span of neutrophils in the bone marrow
2-3 days (mitotic)
5-7 days (maturation and storage)
Part of the innate immune system which replenishes macrophages and dendritic cells and moves quickly to the site of infection (8-12 hours)
Monocyte
Contents of tertiary granules
1 Gelatinase
2 Alkaline phosphatase
Equation if all 9 squares are counted
Cells per mcL = # of cells counted x dilution/9 x 0.1
Start of maturation and storage
Metamyelocyte
Closely resembles the function of granulocyte
Monocyte
Fewer and smaller nuclear folding and cytoplasmic granules than neutrophils
Monocytes
Factors that drive neutrophil maturation
Granulocyte colony-stimulating factor
Movement of neutrophils
Amoeboid motion (pseudopodium)
T or F. Promyelocyte is confined to the bone marrow unlike myelocyte
F. Both are confined to the bone marrow
Scan basophilic cytoplasm without perinuclear halo
Myeloblast
Neutrophils attached to endothelium of blood vessels
Marginal neutrophils
Mature eosinophil
Refractive orange specific granules
Significant proportion of eosinophils are stored in the
spleen
Dependent in passing from bone marrow to peripheral blood and tissues
Cell life
Direct precursor of blood monocyte
Promonocyte
Circulating neutrophils
Free
Survive in tissues longer than neutrophils
Eosinophils
Seen in pathologic states in the blood
Promyelocyte
Myelocyte
Metamyelocyte
Characteristics of neutrophil maturation
1 Decreasing N/C ratio
2 Increasing production of granules
3 Increasing nuclear segmentation
With paranuclear halo
Promyelocyte
Formed during blood film
Smudge cells
Basket cells
Life span if neutrophils in tissues based on in vitro observation of tissue culture
2-3 days
Location of eosinophils
Skin and mucosal surfaces of the respiratory and gastrointestinal tracts
Most immature cells in the bone marrow
Myeloblast
Other term for secondary granules
Specific
Granules formed in promyelocytes
Primary
Rules for counting
1 Count cells on the upper or left line
2 Do not count cells on the bottom or right line
3 Each side should be counted and the average of the 2 should be taken
More condensed nuclear chromatin =
More mature
Predominant WBC
Segmented neutrophil
Nucleus has many shapes twisted/folded on itself
Band
Precursor of most macrophages including dendritic cells
Monocytes
Neutrophil forms in the bone marrow (5-7 days)
Metamyelocytes
Band forms
Segmented neutrophils
Characteristics of monoblast cytoplasm
1 Coarse
2 May show pseudopod formation
3 Vacuoles
First recognizable eosinophil
Promonocyte
Factors thought to play a role in basophil production
1 IL3 2 GM-CSF 3 IL4 4 IL5 5 Stem cell factor (SCF) 6 T cells
Absolute count (x 10^9/L) and relative percent of lymphocytes
1,000-3,000
20-40%
Similar to large tissue mast cells
Basophils
Induces eosinophil formation, function, and prolonged survival
IL5 growth factor
Basophils are increased in blood during
1 Myeloproliferative neoplasms (leukemia) 2 Hypersensitivity reactions 3 Hypothyroidism 4 Iron deficiency 5 Renal disease
Functions of basophils
1 Mediate allergic or hypersensitivity reactions (Type I)
2 Have some phagocytic activity
3 Have a role in immediate hypersensitivity reactions
4 Have a role in delayed type hypersensitivity reactions
5 Have a role in host defense against helminths
Primary and secondary granules are present
Myelocyte
Activate macrophages
T cells
Seen in atopic persons
Increased number of basophil progenitor cells
Main cytokine in basophil production
IL3
Absolute count (x 10^9/L) and relative percent of basophils
20-100
<1-2%
Most important WBC
Lymphocyte
When are necrotic cells seen?
Prolonged exposure to EDTA
Chemotherapy
Largest type of WBC in terms of size
Monocyte
Where does terminal differentiation of mature lymphocytes occur?
Secondary lymphoid organs (mucocutaneous lymph tissues, spleen, lymph nodes)
Life span of neutrophils
9-10 days
Predominant non-granulocyte cells
Lymphocytes
Equation if 4 squares are used
Cells per mcL = # of cells counter x dilution/4 x 0.1
Primary cytokine linked to specific eosinophil and basophil production
IL5
Functions of eosinophils
1 Role in response to parasitic infections and allergic conditions
2 Phagocytosis
3 Respond to chemotactic factors
4 Damage larval stages of parasitic helminths
Nuclear remnants of lymphocytes
Smudge cells
Neutrophil forms in the bone marrow (2-3 days)
Myeloblast
Promyelocytes
Myelocytes
Found in some leukemias
Basket cells
Immature eosinophil
Large blue granules
Progenitor of eosinophils
CFU-GM
What does WBC reflect?
Circulating pool of myeloid and lymphoid cells
Largest of leukocytes
Monocyte
Functions of monocytes
1 Produce macrophages
2 Phagocytosis
Chemotactic factors that attract monocytes
1 Ag-Ab complexes
2 Complement components (C3a and C5a)
3 Factors released by activated T lynphocytes
Recognize and lyse tumor cells and virus-infected cells
NK cells
Released by activated macrophages
1 Substances for inflammatory response
2 Complement system
3 Pyrogens
Its presence in PBS indicates lymphoma
Lymphoblast
Absolute number =
Percentage of each type of WBC x total WBC
Differentiate into plasma cells
B cells
Absolute count (x 10^9/L) and relative percent of neutrophils
2,000-7,000
40-80%
Nuclear remnant of granulocytic cells with net-like chromatin
Basket cells
Abnormal conditions: nucleated RBCs
1 Hemolytic anemia
2 Leukemia
3 Myeloproliferative disorders
Kidney-shaped or U-shaped
Monocyte
Enhance effect of phagocytosis
Bacteriolytic enzyme
Helpful in identifying monocytes
Non-specific esterases
Abnormal conditions: phagocytic cells
1 Overwhelming septicemia
2 Bacterial and fungal infections
3 Erythrophagocytosis
4 Severe infections
Abnormal proliferation of lymphocytes in chronic lymphocytic anemia
Smudge cells
Humoral immune response
Mature B cells
Granulocytic cells with pyknotic nuclei and agranular cytoplasm
Nectrotic cells
Where monocytes differentiate into macrophages
Tissues
Collection tube
EDTA with potassium salt additive as anti-coagulant
When is hemocytometer used?
1 Automated cell counters and hematology analyzers are unavailable
2 Blood cell counts are extremely low
3 To get cell count for body fluids (spinal fluid, joint fluid, semen counts, etc)
Sometimes called basket cells
Smudge cells
Round or oval nuclei with clefts
Myeloblast
Neutrophil that has engulfed foreign substances
Phagocytic cells
Characterized by its ability to be stained by basic dyes
Basophil
Made of heavy glass with 2 counting areas
Glass hemocytometers
Activate basophils to release histamine in delayed type hypersensitivity reactions
T cells
Antigen presenting cells
Activated macrophages
Abnormal conditions: megakaryocyte fragments
1 Aberrant platelet production
2 Myelofibrosis
3 Essential thrombocythemia
Has potential antineoplastic effect
Bacteriolytic enzyme
Materials of a hemocytometer
Neubauer’s slide
Cover slip
RBC pipette
WBC pipette
Nude nuclei
Megakaryocyte fragments
Regulatory and effector functions
T cells
Nucleus of monoblasts
1 Round/oval nuclei with fine chromatin
2 1-4 large prominent nucleoli
3 May show indentations or folding
Explain: Lymphocytes are not obligate end cells
During maturation, lymphocytes continuously supply the body with incompletely differentiated cells
The area used for counting more than a few cells
4 outer squares
Few may be found in normal condition
Smudge cells
Basket cells
Contaminant of venipuncture
Endothelial cells
Contents of granules of eosinophils
Lysosomal enzymes 1 acid phosphatase 2 beta-glucoronidase 3 lysozyme 4 lipase 5 peroxidase 6 non-specific esterases
Provides relative % of each type of WBC
WBC Differential Count
Advantages of absolute count
1 Gives more meaningful information
2 Useful for monitoring
3 Abnormal conditions can be identified
The area used for counting a few cells
Entire chamber
Total WBC count =
4,500-10,000/mcL
Difference between automated and manual differential blood counts
(Review)
Indicates bacterial type of infection
Neutrophil
Indicates viral type of infection
Lymphocyte
Absolute count (x 10^9/L) and relative percent of monocytes
200-1,000
2-10%
Shift to the left indicates
1 infection
2 exercise or stress
Used to diagnose blood disorders
Monocytes
Absolute count (x 10^9/L) and relative percent of eosinophils
20-500
1-6%
Found in newborns in normal condition
Megakaryocyte fragments
Nucleated RBCs
Aids in the diagnosis of disease
Interpretation of differential count (together with CBC)
Specimen
Whole blood
Structureless chromatin
Smudge cell