benign leukocytoses
TRANSCRIPT
Benign LeukocytosesKristine Krafts, M.D.
• Neutrophilia
• Lymphocytosis
• Basophilia
• Monocytosis
• Eosinophilia
Benign Leukocytoses
• Neutrophils fight infection, participate in inflammatory responses
• Bone marrow• Most neutrophils live here• All stages of maturation
• Blood• Only 5% of all neutrophils are here• Normally only segmented neutrophils• Half are marginated
Neutrophilia
• Mature (lots of segmented neutrophils)
• Immature (lots of immature neutrophils)
Types of Neutrophilia
Mature neutrophilia
• Bacterial infection
• Inflammation
• Physiologic things• Stress• Hormones
Causes of Mature Neutrophilia
• Toxic granulation
• Döhle bodies
• cytoplasmic vacuolization
Clues to Bacterial Infection
Sometimes, bacterial infections produce “toxic” changes in neutrophils!
Normal neutrophil(top left)
Neutrophil with toxic granulation
Promyelocyte
Döhle bodies
Cytoplasmic vacuolization
Immature neutrophilia
• Bacterial infection
• Inflammation
• Severe anemia
• Something filling up the marrow
Causes of Immature Neutrophilia
• Left shift
Two Forms of Immature Neutrophilia
blast promyelocyte myelocyte band segmented neutrophilmetamyelocyte
Left shift
• Left shift
• Leukoerythroblastotic reaction
Two Forms of Immature Neutrophilia
Leukoerythroblastotic reaction
• Left shift
• Leukoerythroblastotic reaction• Sometimes due to severe anemia• Sometimes due to something
filling up the bone marrow
Two Forms of Immature Neutrophilia
• Lymphocytes fight infection, participate in immunologic responses
• Normal lymphocyte count• Varies a lot with age!• Bigger normal range in infants
• Normal immunophenotype in blood• T cells: 80%• B cells: 15%• NK cells: 5%
Lymphocytosis
• Mature (lots of mature lymphocytes)
• Reactive (lots of funny-looking lymphocytes)
Types of Lymphocytosis
Mature lymphocytosis
• Infectious lymphocytosis
• Bordetella pertussis
• Transient stress
Causes of Mature Lymphocytosis
Reactive lymphocytosis
Downey cells
IIIIII
• Infectious mononucleosis
• Pediatric viral infections
• Viral hepatitis
• Immune disorders
Causes of Reactive Lymphocytosis
• Basophilia• CML• CML• CML
Other Benign Leukocytoses
•Basophilia
• Basophilia
• Eosinophilia• Drugs• Asthma• Skin diseases• Parasites
Other Benign Leukocytoses
•Eosinophilia
• Basophilia
• Eosinophilia
• Monocytosis• Infection• Autoimmune disease• Malignancy
Other Benign Leukocytoses
•Monocytosis