WBC Abnormalities/ Anomalies & WBC Lab Evaluation Flashcards
Pancytopenia
severe decrease in all of the blood cells in the PB
Panhypercellular
increase in all of the blood cells in the PB
Leukocytosis
Increase in the total WBC count
Leukopenia
Decrease in the total WBC count
Granulocytopenia
Decrease in the # of granulocytes
Granulocytosis
Increase in granulocytes
Neutrophilia
Increase in # of neutrophils
most common cause is bacterial infections
Neutropenia
Decrease in # of neutrophils
Eosinophilia
increase in # of eosinophils
Eosinopenia
Decrease in # of eosinophils
Basophilia
Increase in # of basophils
Basopenia
Decrease in # of basophils
Lymphocytosis
Increase in # of lymphocytes
Lymphocytopenia
Decrease in # of lymphocytes
monocytosis
increase in the # of monocytes
Monoctyopenia
Decrease in the # of monocytes
Reactive Neutrophilia
occurs as a reaction to a physiologic/pathologic process
can be immediate, acute or chronic
Immediate Neutrophilia
seen in active exercise, epinephrine, anesthesia, anxiety
lasts 20-30 minutes
independent of BM input
Acute Neutrophilia
occurs within 4-5 hours of stimulus- bacterial infection/toxin
increase flow of segs from BM storage to PB
Chronic Neutrophilia
follows acute if stimulus persists
increase production in mitotic pool
Leukomoid Reaction
extreme neutrophilic reactions
too high WBC count for a bacterial infection
>50x10^9
left shift! (immature leukocytes circulating)
may resemble CML
Hypersegmentation of Neutrophils
neutrophil with 6+ lobes
seen in:
megaloblastic anemias & chronic infections
Hyposegmentation of Neutrophils
neutrophil with 2 or fewer lobes
‘peanut’ or ‘dumbbell’ shaped
seen in:
Pelger-Huet (genetic anomaly: cells function normally)
Pyknotic (Pyknosis)
dying neutrophils related to apoptosis seen in: infections artifact malignancies
Toxic Granulation
Large, dark granules in the cytoplasm of neutrophils
composed of primary granules
seen in: bacterial infections, inflammatory conditions, burns, cancer, toxic drugs
Toxic granulation, Dohle bodies and cytoplasmic vacuoles are frequently seen together
Dohle Bodies
pale blue, round, oval, or rod shaped inclusions in the cytoplasm of neutrophils & eosinophils
VERY HARD TO SEE
composed of ribosomal RNA
seen in: bacterial infections, burns, cancer, toxic drugs, May-Hegglin anomaly
Vacuolization/ cytoplasmic vacuoles
bubbles/ open areas within the cytoplasm
seen in: bacterial infections, burns, cancer, toxic drugs, inflammation
evidence of phagocytic activity
Auer Rods
red-purple small rods
found within the cytoplasm of BLAST cells
composed of fused primary granules
Degranulation of Neutrophils
‘hypogranulation’
absence of granules
seen in: infections, myelodysplastic syndrome, myeloproliferative neoplasms
Alder-Rielly Anomaly
purple/red granules seen in all leukocytes
Very pronounced granulation
easily confused with toxic granulation
blood cells function normally
Chediak-Higashi syndrome
Very large bluish granules appear in neutrophils & lymphocytes composed of fused primary & secondary granules
cells do not function normally (do not kill microbes)
death usually occurs in infancy or childhood
hypopigmentation of skin, silvery hair, photophobia
May-Hegglin anomaly
Dohle-like inclusions in mature WBCs composed of RNA
usually larger & more round in shape than Dohle bodies
cells function normally
Myeloperoxidase Deficiency
defective microbicidal activity
benign hereditary disorder
slower killing of microbes
no clinical consequence
Reactive Eosinophilia
infections with helminthic parasites
allergic diseases
Basophilia
> 0.2x10^9/L thyroid insufficiency inflammatory reactions chronic myeloproliferative diseases basophilic leukemia
Reactive Monocytosis
chronic infectious processes (bacterial)
inflammatory & immune disorders
chronic neutropenic disorders
Basket Cell
nuclear remnants from smear prep
Smudge Cells
smudged nucleus during smear prep
common in chronic lymphocytic leukemia due to increased cell fragility
Manual WBC count
(# of cells counted)/ (# of squares x L x W x D) multiplied by dilution factor
Interpreting Leukocytosis
slight elevations = bacterial infections
extreme elevations = leukemias
Interpreting Leukopenia
viral infections
chemotherapy
Interpreting Neutrophilia
inflammation
bacterial infections
myelocytic leukemia
leukomoid reaction
Interpreting Lymphocytosis
increase in atypical lymphs in a young adult/teenager can indicate infectious mononucleosis (viral infection)
Interpreting Monocytosis
during recovery phase from acute infections
TB
monocytic leukemia
Interpreting Eosinophilia
allergies
parasites
granulocytic leukemia
Interpreting Basophilia
granulocytic leukemias
severe allergic reactions
Interpreting Neutropenia
acute viral infection
bone marrow damage
overwhelming infection (BM exhausted)
chemo
Interpreting Lymphopenia
radiation poisoning
cortical steriods
sepsis
Left Shift
immature cells that are not usually present in the PB
Flipped Diff
more lymphocytes than segs
Nucleated RBC count
(WBC count x100)/ (100+# of NRBCs) = corrected WBC count
