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12 Cards in this Set
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- Back
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What are normal levels of WBC
Define Leukocytosis and Leukopenia |
Total WBC = 3,500-12,000 /µL
Leukocytosis = WBC count of > 12,000/µL Leukopenia = WBC count of < 3,500/µL |
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Differential WBC
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the % of each cell type present in the peripheral blood sample
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Normal absolute cell counts in WBC differential
Segmented neutrophils lymphocytes monocytes eosinophils basophils |
Segmented Neutrophils = 1500 - 8000
Lymphocytes = 1300 - 4000 Monocytes = 0 - 800 Eosinophils = 0 - 450 Basophils = 0 - 200 |
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Lymphocytopenia
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Absolute lymphocyte count is < 1300
Due to congenital immunodeficiency, HIV, certain drugs |
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Reactive Lymphocytosis
2 types: 1st is reactive with transformed and atypical lymphocytes, the 2nd is reactive with non-transformed, small mature appearing lymphocytes |
This is when lymphocytes become large as a result of infection
Absolute lymphocyte count > 4000 1) Transformed - They are large but do vary in size, have abundant cytoplasm which can be clear or basophilic and the nuclei are large and irregular The peripheral blood smear shows heterogeneous picture Due to - viral hepatitis, cytomegalovirus, herpes, adenovirus etc 2) Non-Transformed. Due to - Pertussis (whooping cough), infectious lymphocytosis |
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Neoplastic Lymphocytosis
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Leukemia - lymphocytosis that begins in the bone marrow and is expressed in the peripheral blood
Lymphoma - lymphocytosis that begins in the tissue (lymph node, spleen, GI Tract...) There can be cross over between the 2. For example leukemia can send cancer into the blood and it invades a lymph node. If this happens it's called "Lymphocytic Leukemia/lymphoma" |
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Morphology of neoplastic lymphocytes in peripheral blood
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Depends on the type of leukemia or lymphoma the patient has.
MOST IMPORTANT is that the neoplastic lymphocytes will be a homogeneous population. All the cells look the same, this is opposite to reactive lymphocytosis where they grow and are all different |
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Chronic Lymphocytic Leukemia (CLL)
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A chronic neoplastic (clonal) lymphoproliferative disorder of SMALL MATURE B-LYMPHOCYTES
Clinical Presentation Most common leukemia of middle-aged/elderly aduts often it's asymptomatic weakness, weight loss Generalized lymphadenopathy |
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Lab findings of Chronic Lymphocytic Leukemia (CLL)
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Hall mark of CLL is Sustained peripheral blood lymphocytosis
Morphologically SMALL, monotonous, MATURE lymphocytes with condensed (hyperchromatic) chromatin & "bloack-type" smudged cells (basket cells) Most have anemia, hypogammaglobulinemia Clonal, mature B-lymphocytes |
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CLL / SLL similarities and differences
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CLL - chronic lymphocytic leukemia
SLL - Small lymphocytic leukemia CLL and SLL are morphologically, genotypically, phenotypically identical but they differ in their clinical distribution lymphocytes circulate and often infiltrate lymph nodes and spleen |
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Hairy Cell Leukemia
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A clonal lymphoproliferative disorder of mature B-cells. Rare
Clinical Presentation Adults (~50 years) more common in men Splenomegaly (can be massive) fatigue, recurrent infection, abdominal discomfort Lab Findings Pancytopenia (anemia, leukopenia, thrombocytopenia) Neutropenia Monocytopenia Circulating abnormal lymphocytes ("Hairy Cells") |
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What distinguishes Hairy Cell Leukemia from Chronic Lymphcytic leukemia (CLL)
What is the clinical course |
Splenomegaly but NO lymphadenopathy
Pancytopenia (reduction in all types of blood cells... Red and White) not leukocytosis Hairy cells not small lymphocytes Bone marrow is NOT ASPIRABLE TRAP (Tartrate Resistant Acid Phosphatease) stain Clinical Course Long lasting remissions with newer chemo agents 2CDA, deoxycoformycin and alpha-interferon |
