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Comparison of Leukocyte Conditions: Difference between revisions

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Created page with "{| class="wikitable" |+ !Condition !Characteristics !Causes ! |- |Normal adult | | | |- |Normal neonate | | | |- |Normal child (1-3 years) | | | |- |Normal geriatric adult | | | |- |Bacterial infection | | | |- |Leukemoid Reaction | | | |- |Leukoerythroblastic picture | | | |- |Basophilia | | | |- |Eosinophilia | | | |- | | | | |- |Pelger-Huët Anomaly | | | |- |Alder-Reilly Anomaly | | | |- |May-Hegglin Anomaly | | | |- |Chediak-Higashi Syndrome | | | |} Granulocyte Alt..."
 
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!Characteristics
!Characteristics
!Causes
!Causes
!
!Other Information
!Comorbidities/Associated Conditions
|-
! colspan="5" |Normal Patients
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|Normal adult
|Normal adult
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|Pre-term neonate
|Left shift
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|Normal neonate
|Normal neonate
|↑ WBC, % neuts
many segs/bands
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|Normal child (1-3 years)
|Normal child (1-3 years)
|↑ % lymphs (~2x neuts)
"Reverse ratio/inverted diff"
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|Normal geriatric adult
|Normal geriatric adult (>65)
|↓ RBC, WBC, HGB
↑ MCV (slight)
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! colspan="5" |Clinical Conditions
|-
|-
|Bacterial infection
|Bacterial infection
|Abs neutrophilia
Left shift
↑ Bands
-/↑ Metamyelocytes and myelocytes
Toxic changes (toxic granulation and vacuolation)
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|-
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|Leukemoid Reaction
|Leukemoid Reaction
|>50×10<sup>9</sup>/L leukocytosis
neutrophilia
left shift
Usually only affects neuts
|
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|
* Severe or chronic infection
* Metabolic disease
* Inflammation
* Malignancy (immune response to)
|Often confused with CML!
Leukemoid reaction usually only affects neuts!
 
CML affects all granulocytes (especially eos and basos), and often causes anemia.
|
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|-
|-
|Leukoerythroblastic picture
|Leukoerythroblastic picture
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|Immature neuts
NRBCs
Teardrop cells
Often has neutrophilia
|Lesion in bone marrow
 
* Metastatic tumour
* Fibrosis, especially primary myelofibrosis
* Lymphoma
* Leukemia
* Hyperplasias
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|-
|-
|Basophilia
|Basophilia
|
|Abs basophilia (>0.15×10<sup>9</sup>/L)
|Non-malignant
 
* Insect stings
* Food or drug hypersensitivity
* Chronic infections
* Hypothyroidism
* Chronic inflammation
* Radiation therapy
 
Malignant
 
* Chronic myelogenous leukemia
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|-
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|Eosinophilia
|Eosinophilia
|Abs eosinophilia (>0.4×10<sup>9</sup>/L)
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* Allergies
* Parasitic infection
* Autoimmune disorders
* Fungal infections
* Acute lymphoblastic leukemia
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|-
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|Pelger-Huët Anomaly
|Pelger-Huët Anomaly
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|Alder-Reilly Anomaly
|Alder-Reilly Anomaly
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|May-Hegglin Anomaly
|May-Hegglin Anomaly
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|Chediak-Higashi Syndrome
|Chediak-Higashi Syndrome
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** May-Hegglin Anomaly
** May-Hegglin Anomaly
** Chediak-Higashi Syndrome
** Chediak-Higashi Syndrome
=== Reporting Leukocyte Morphology ===
{| class="wikitable"
|+
!
!
!
!
|-
|WBCs
|SD/D/N/SI/I
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|-
|Platelets
|SD/D/N/SI/I
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|-
| colspan="4" |'''Differential'''
|-
|Neutrophils
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* All mature AND band neutrophils
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|Lymphocytes
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* All mature lymphocytes, including reactive/atypicals
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|Monocytes
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* All mature monocytes
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|Eosinophils
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* All eosinophil lineage, including immature
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|Basophils
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* All basophil lineage, including immature
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|Metamyelocytes
| rowspan="2" |
* Neutrophil lineage only
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|Myelocytes
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|Promyelocytes
| rowspan="2" |
* All cell lines
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|Blasts
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|Smudge Cells
|ONLY report if in large numbers AND consistent with CLL (Chronic Lymphocytic Leukemia)
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|Other Cells
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* Hairy cells
* Plasma cells
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|Total
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|NRBC
|x per 100 WBCs
* Report if >0
* If ≥ 10, correct WBC count for NRBCs
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| colspan="4" |WBC Morphology
|-
|Bands
|Some/Many AND report Moderate/Marked left shift
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|Toxic granulation
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|Toxic vacuolation
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|Hypersegmented neutrophils
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|Hyposegmented neutrophils
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|Dohle bodies
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|Reactive lymphs
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| colspan="4" |Platelet Morphology
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|Giant Platelets
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|Platelet Clumps
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| colspan="4" |Comments
|-
|Other Comments
|See below.
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|}
==== Report Under Comments: ====
* Moderate/Marked Left Shift (immature neutrophils)
* Immature WBCs
** Neutrophilic bands (>5% of neuts)
** Eosinophilic metamyelocytes
** Eosinophilic myelocytes
** Basophilic metamyelocytes
** Basophilic myelocytes
** Prolymphocytes
** Promonocytes
* Pelger-Huet forms
* Abnormal granulation
** Chediak-Higashi
** Alder-Reilly
*Leukemoid reaction
* Auer rods
* Folded cells
* Bite/Blister cells
* Microspherocytes
* Intracellular/Extracellular Organisms
** Bacteria
** Malarial parasites
** Other parasites
* Hemoglobin Crystals
** Hemoglobin C
** Hemoglobin S/C
* Background staining
==== Possible Clinical Conditions: ====

Latest revision as of 18:42, 22 February 2024

Condition Characteristics Causes Other Information Comorbidities/Associated Conditions
Normal Patients
Normal adult
Pre-term neonate Left shift
Normal neonate ↑ WBC, % neuts

many segs/bands

Normal child (1-3 years) ↑ % lymphs (~2x neuts)

"Reverse ratio/inverted diff"

Normal geriatric adult (>65) ↓ RBC, WBC, HGB

↑ MCV (slight)

Clinical Conditions
Bacterial infection Abs neutrophilia

Left shift

↑ Bands

-/↑ Metamyelocytes and myelocytes

Toxic changes (toxic granulation and vacuolation)

Leukemoid Reaction >50×109/L leukocytosis

neutrophilia

left shift

Usually only affects neuts

  • Severe or chronic infection
  • Metabolic disease
  • Inflammation
  • Malignancy (immune response to)
 Often confused with CML!

Leukemoid reaction usually only affects neuts!

CML affects all granulocytes (especially eos and basos), and often causes anemia.

Leukoerythroblastic picture Immature neuts

NRBCs Teardrop cells Often has neutrophilia

Lesion in bone marrow
  • Metastatic tumour
  • Fibrosis, especially primary myelofibrosis
  • Lymphoma
  • Leukemia
  • Hyperplasias
Basophilia Abs basophilia (>0.15×109/L) Non-malignant
  • Insect stings
  • Food or drug hypersensitivity
  • Chronic infections
  • Hypothyroidism
  • Chronic inflammation
  • Radiation therapy

Malignant

  • Chronic myelogenous leukemia
Eosinophilia Abs eosinophilia (>0.4×109/L)
  • Allergies
  • Parasitic infection
  • Autoimmune disorders
  • Fungal infections
  • Acute lymphoblastic leukemia
Pelger-Huët Anomaly
Alder-Reilly Anomaly
May-Hegglin Anomaly
Chediak-Higashi Syndrome

Granulocyte Alterations & Anomalies

  • Acquired
    • Hyposegmented nucleus
    • Hypersegmented nucleus
    • Pyknotic and necrobiotic nuclear forms
    • Toxic granulation of cytoplasm
    • Degranulation
    • Vacuolization
    • Döhle bodies
    • LE cells
    • Auer rods
    • Pseudo-Pelger-Huët Anomaly
  • Inherited
    • Pelger-Huët Anomaly
    • Alder-Reilly Anomaly
    • May-Hegglin Anomaly
    • Chediak-Higashi Syndrome

Reporting Leukocyte Morphology

WBCs SD/D/N/SI/I
Platelets SD/D/N/SI/I
Differential
Neutrophils
  • All mature AND band neutrophils
Lymphocytes
  • All mature lymphocytes, including reactive/atypicals
Monocytes
  • All mature monocytes
Eosinophils
  • All eosinophil lineage, including immature
Basophils
  • All basophil lineage, including immature
Metamyelocytes
  • Neutrophil lineage only
Myelocytes
Promyelocytes
  • All cell lines
Blasts
Smudge Cells ONLY report if in large numbers AND consistent with CLL (Chronic Lymphocytic Leukemia)
Other Cells
  • Hairy cells
  • Plasma cells
Total
NRBC x per 100 WBCs
  • Report if >0
  • If ≥ 10, correct WBC count for NRBCs
WBC Morphology
Bands Some/Many AND report Moderate/Marked left shift
Toxic granulation
Toxic vacuolation
Hypersegmented neutrophils
Hyposegmented neutrophils
Dohle bodies
Reactive lymphs
Platelet Morphology
Giant Platelets
Platelet Clumps
Comments
Other Comments See below.

Report Under Comments:

  • Moderate/Marked Left Shift (immature neutrophils)
  • Immature WBCs
    • Neutrophilic bands (>5% of neuts)
    • Eosinophilic metamyelocytes
    • Eosinophilic myelocytes
    • Basophilic metamyelocytes
    • Basophilic myelocytes
    • Prolymphocytes
    • Promonocytes
  • Pelger-Huet forms
  • Abnormal granulation
    • Chediak-Higashi
    • Alder-Reilly
  • Leukemoid reaction
  • Auer rods
  • Folded cells
  • Bite/Blister cells
  • Microspherocytes
  • Intracellular/Extracellular Organisms
    • Bacteria
    • Malarial parasites
    • Other parasites
  • Hemoglobin Crystals
    • Hemoglobin C
    • Hemoglobin S/C
  • Background staining

Possible Clinical Conditions:

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