Reactive And Inherited Leukocytic Disorders Of Blood And Marrow

Question 1

What are the mechanisms of leukocytosis?

Answer 1

Increased production in the marrow
Increased release from marrow stores
Decreased margination
Decreased extravasation into tissues

Question 2

What are the causes of increased production in the marrow?

Answer 2

Chronic infection/ inflammation
Paraneoplastic syndromes
Myeloproliferative neoplasms

Question 3

What are the causes for increased release from marrow stores?

Answer 3

Endotoxemia
Infection
Hypoxia
Trauma/surgery

Question 4

What are the causes of decreased margination?

Answer 4

Exercise
Catecholamines
Infections (early)

Question 5

What are the causes of decreased extravasation into tissues?

Answer 5

Glucocorticoids

Question 6

What are the causes of neutrophilic leukocytosis?

Answer 6

Acute bacterial infections especially pyogenic- most common
Sterile inflammation ( tissue necrosis,vasculitis)
Some medications

Question 7

What are the characteristics morphologic features in neutrophilic leukocytosis?

Answer 7

Toxic granulation
Dohle bodies
Cytoplasmic vacuoles

Question 8

What are the characteristics of leukemoid reaction?

Answer 8

Severe persistent reactive neutrophilic leukocytosis above 50k
Present with leukocytosis, granulocytic left shift and thrombocytosis

Question 9

What is leukoerythroblastosis?

Answer 9

Immature myeloid and erythroid precursors in Peripheral blood
Caused by myelophthisis= space occupying lesion in marrow
Nucleated RBC present
Variable degree of leukocytosis

Question 10

What is bone marrow myeloid hyperplasia?

Answer 10

Reactive disorders of granulocytes
Increased number of immature myeloid cells in the marrow
Caused by infections and administration of growth factors
May also be seen in myeloid neoplasms

Question 11

What are some causes of eosinophilia?

Answer 11

Allergic disorders
Parasitic infections/infestations
Drug reactions

Question 12

What are the causes of basophilia?

Answer 12

Rare
Usually indicates disorder such as chronic myeloid leukemia
Can be seen in myxedema, UC, lymphoma

Question 13

What are the causes of monocytosis?

Answer 13

Chronic infections
Recovery from neutropenia
Inflammatory diseases

Question 14

What are the causes of lymphocytosis?

Answer 14

Transient stress reaction secondary to epinephrine release
Accompanies monocytosis in many chronic disorders with immunologic sitimulation(TB)
Viral infections (EBV,CMV)

Question 15

What are the non neoplastic causes of neutropenia?

Answer 15

Proliferation defects- drug including chemo most common
Maturation defect- megaloblastic anemia
Survival defect- myeloid hyperplasia
Distribution abnormality- variable bone marrow appearance

Question 16

What are the causes of lymphocytopenia?

Answer 16

Congenital deficiency
Infectious diseases (HIV,Ehrlichiosis)
Iatrogenic ( drugs, radiation,surgery)

Question 17

What are the causes of monocytopenia?

Answer 17

Aplastic anemia
Hairy cell leukemia
Corticosteroids

Question 18

What are the non neoplastic bone marrow abnormalities?

Answer 18

Reactive plasmacytosis
Reactive lymphoid aggregates
Granulomas- may be seen with any infection
Polycythemia and erythroid hyperplasia

Question 19

What are some inherited disorders of leukocytes?

Answer 19

Pelger-Huet anomaly: hyposegmented neutrophils, autosomal dominant
May-Hegglin anomaly: asymptomatic, large platelets and Dohle body like inclusions, no bleeding tendency
Chediak-Higashi syndrome:large abnormal granules, mimic infectious diseases, most victims die in childhood from infections or bleeding
Alder-Reilly anomaly:heavy granulation resembling toxic granulation, type of lysosomal storage disease