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Clinical Pathology > Lymphocytes > Flashcards

Lymphocytes Flashcards

1
Q

Lymphocyte size

A
  • small: 1-1.5 erythrocytes
  • medium: 1.5-2 erythrocytes
  • large: more than 2 erythrocytes
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2
Q

Lympocyte recirculation - blood

A

Most are T lymphocytes

- CLP and MLP

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3
Q

Lymphocyte recirculation - lymph nodes

A

Enter cortices via specialized postcapillary venules

  • exit via efferent lymphatic vessels
  • 25% enter lymph nodes each day
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4
Q

Lymphocyte recirculation - tissue

A

Blastogenesis, recirculate, or die

- migration from vessels to tissue similar to neutrophils

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5
Q

Lymphocyte recirculation - blood concentration

A

Production (stem cell or blastogenesis)

  • CLP and MLP
  • life span: hours to years
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6
Q

Lymphocytosis

A

Chronic inflammatory

  • chronic antigenic or cytokine stimulus
  • reactive lymphocytes may be present
  • enlarged lymph nodes or lymphoid organs (reactive lymphoid hyperplasia)
  • mild to moderate: 2-3 URL
  • neutrophilia, monocytosis
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7
Q

Physiologic lymphocytosis

A
  • catecholamines
  • MLP to CLP
  • 2 x URL
  • minutes to hours
  • no morphologic change
  • may cause large granular lymphocytes to increase
  • would not see reactive lymphocytes!!
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8
Q

Lymphoproliferative disease

A
  • neoplastic proliferation
  • lymph nodes, BM
  • BLV (neoplastic or not) and FeLV
  • leukemia may be leukemic manifestation of lymphoma
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9
Q

Leukemia

A

Marked lymphocytosis, with cells displaying immature features

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10
Q

Hypoadrenocorticism

A

Due to lymphocytosis

  • lack of glucocorticoids (limit lymphocyte production and alter distribution)
  • dogs: neutropenia with lymphocytosis and azotemia
  • may see high normal to mild eosinophilia
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11
Q

Young animal lymphocytosis

A

Puppies, kittens, calves, foals

- cattle: increases until 1 year old and then gradually decreases up to 2 x URL

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12
Q

Lymphopenia due to acute inflammatory

A

Change in lymphocyte kinetics decreasing CLP

- may be caused by stress, but not documented

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13
Q

Lymphopenia due to steroid

A

Change in lymphocyte kinetics, decreasing CLP

  • endogenous and exogenous glucocorticoids
  • immediate: shift from CLP to other pools (may be entrapped in lymph nodes or BM)
  • later: lymphotoxic effects leading to lymphoid hypoplasia
  • most common cause of lymphopenia
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14
Q

Lymphopenia due to depletion

A

Loss of lymphocytes due to incomplete circulation

- repeated chylothoracic fluid removal in cats

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15
Q

Lymphopenia due to lymphoid hypoplasia or aplasia

A

Congenital or acquired

  • decrease lymphocyte production
  • selective T lymphocyte hypoplasia/aplasia will cause more severe lymphopenia than selective B lymphocyte hypoplasia/aplasia
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16
Q

Lymphopenia due to lymphoma

A

Decrease production or altered kinetics

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17
Q

Monocytes

A

Stem cell (CFU-GM)

  • CMP and MMP
  • emigration
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18
Q

Mononuclear phagocyte system

A
  • macrophages: Kupffer cells, alveolar macrophages, type A synoviocytes
  • microglial cells
  • dendritic cells: Langerhans cells (skin), interdigitating cells (lymph nodes)
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19
Q

Inflammatory monocytosis

A

Acute and chronic inflammation

- cytokine stimulation: production and release

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20
Q

Monocytosis due to steroid

A

Common in dogs and cats, minimal horses and cattle

- shift from MMP to CMP

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21
Q

Neoplastic monocytosis

A
  • monocytic leukemia
  • marked monocytosis
  • normal or abnormal monocytes
  • uncommon when compared to granulocytic and lymphoid leukemias
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22
Q

Monocytosis secondary to immune-mediated neutropenia

A

Monocytes and neutrophils share common progenitor

  • may increase monocytopoiesis when stimulating neutropoiesis
  • antibodies destroying neutrophils, not monocytes
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23
Q

Monocytosis due to cyclic hematopoiesis

A

Mild during neutropenic cycles

- herald increase neutrophil concentration

24
Q

_____ treatment may increase production of neutrophils and monocytes

A

G-CSF

25
Q

Is monocytopenia a diagnostic problem?

A

No, hard to document due to already low LRL for monocyte concentration

26
Q

Eosinophils

A

Differentiation: IL-5, GM-CSF

  • CEP and MEP (minutes to hrs in blood)
  • tissue: bactericidal properties, inactivate mast cell mediators, attack parasite larvae and adult stages
27
Q

Eosinophilia

A

Due to anti-inflammatory function

- attraction after mast cell or basophil degranulation

28
Q

Causes of eosinophilia

A
  • hypersensitivity
  • internal/external parasites
  • inflammation in mast cell rich tissues
  • occasionally in hypoadrenocorticism (lack of cortisol)
29
Q

Idiopathic hypereosinophilic syndrome

A

Cats, dogs, horses

  • persistent marked eosinophilia without apparent cause
  • no features suggestive of leukemia
  • hypereosinophilic = 20,000
30
Q

Paraneoplastic eosinophilia

A

Mast cell neoplasms

  • other neoplasms that can release IL-5
  • dogs: T cells, thymoma, mammary carcinomas, oral fibrosarcoma, rectal adenomatous polyps
  • cat: transitional cell carcinoma, T cells, alimentary lymphoma
  • horses: intestinal lymphomas
31
Q

Basophilia

A

Only persistent above (200-300 should be considered due to imprecision of differential counts
- allergic, parasitic, neoplastic stress

32
Q

Basopenia

A

Hard to document due to already low LRL for basophiil concentration
- not clinically relevant

33
Q

Toxic neutrophils

A
  • foamy cytoplasm: cytoplasmic clearing due to dispersed organelles
  • diffuse cytoplasmic basophilia: retention of RNA during maturation
  • Dohle’s bodies: aggregates of rough ER
  • giant neutrophils: larger neutrophils due to asynchronous maturation
34
Q

Toxic neutrophils represent maturation defects caused by _______

A

Rapid neutropoiesis

- due to inflammation

35
Q

Hypersegmented neutrophils

A
  • more than 5 lobes
  • typically old neutrophils (glucocorticoids)
  • myelodysplastic syndromes involving neutrophilic cell line
  • found in poodle marrow dyscrasia
36
Q

Reactive lymphocytes

A

Acute and chronic inflammation

- difficult to differentiate from atypical (neoplastic) lymphocytes

37
Q

Monocytes with features of macrophages

A
  • abundant gray cytoplasm
  • with/out vacuolation
  • seen in systemic infections (histo, ehrlichiosis, babesiosis, leishmaniasis)
38
Q

Sideroleukocytes

A

Neutrophil or monocyte containing hemosiderin

- rare, but seen with hemolytic anemia, or after transfusions

39
Q

Erythorphage

A

Neutrophil or macrophages with phagocytized erythrocyte

  • occasionally seen in IMHA
  • idiopathic immune mediated anemia in dogs
  • equine infectious anemia
  • neonatal isoerythrolysis
40
Q

Lupus erythematosus cells

A

Neutrophil that phagocytized nuclear antigen-antibody complexes
- pink to pale basophilic inclusion of variable sizes

41
Q

Bacteria in leukocytes other than from the family Anaplasmacetae

A

Rare in patients with bacteremia

- bacteria in blood: true bacteremia, or contamination of the sample

42
Q

Bacteria from the family Anaplasmacetae

A

Invade and multiply in blood leukocytes

  • monocytic tend to be more species specific
  • leukocytic ones are less specific
43
Q

Canine distemper inclusions

A
  • monomorphic or pleomorphic
  • red to purple
  • neutrophils, monocytes, lymphocytes, erythrocytes
44
Q

H. americanum

A

Gametocytes infect neutrophils and monocytes

45
Q

H. canis

A

Gametocytes infect neutrohpils and monocytes

  • Europe, Asia, Africa, SA
  • lack clinical signs
46
Q

Histoplasma capsulatum

A

Single or multiple in the cytoplasm of neutrophils, monocytes, or eosinophils

  • yeast phase
  • 2-4
  • eccentric basophilic region with nuclear material
47
Q

Leishmania

A

Kinetoplastid protozoan found primarily in the Mediterranean, central, and SA countries

  • Ohio, Oklahoma, Texas, Maryland, Southeastern states
  • amastigotes found in macrophages
48
Q

Mycobacterium

A

Rarely systemic, can be seen in neutrophils or monocytes

  • wont stain with Wright
  • cytoplasm has cracks in it
49
Q

Toxoplasma gondii

A

Tachyzoites rarely found in blood neutrophils and monocytes

- more common in macrophages of infected organs

50
Q

Leukocyte adhesion deficiency

A
  • irish red and white setters, Holstein cattle
  • canine LAD, bovine LAD
  • defects in the integrin CD18
  • no functional CD11/CD18
  • necessary for adherence, migration, aggregation
51
Q

LAD in dogs

A

Persistent leukocytosis and granulocytic hyperplasia in BM

  • susceptible to infections
  • PCR diagnosis
52
Q

LAD in cattle

A

Marked neutrophilia and recurrent infection

- PCR diagnosis

53
Q

Pelger-Huet anomaly

A

Hyposegmentation of neutrophils, eosinophils, and basophils

  • nuclear chromatin: hyperchromatic or normochromatic
  • dogs, domestic shorthair cats and arabian horses
  • is NOT a band because chromatin is condensed!
54
Q

Pseudo Pelger-Huet neutrophils and eosinophils

A
  • neutrophils: cow, dogs with severe inflammation, and cats with FeLV myeloid leukemia
  • transient due to asynchronous maturation
  • eosinophils: cattle and horse (w/ neutrophils)
55
Q

Nonstaining eosinophil granules (grey) of dogs

A

Poor staining eosinophil granules or just the vacuoles, and grey cytoplasm

  • greyhounds, golden retrievers, sheepdog
  • modified chemical composition
  • no pathological significance
  • maybe misclassified by counters

Clinical Pathology (9 decks)

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