leucocytes Benign Disorders

Nada Mohamed Ahmed ,MD, MT (ASCP)i

Contents. Definitions Classification Benign WBCs disorders

QuantitativeChange in number

QualitativeChange in (function & structure)

LEUCOCYTES BENIGN DISORDERS

Terminology Cytosis / philia

Increase in number Cytopenia

Decrease in number

Relative vs Absolute values Total white blood cell count Differential count Absolute count

Differential gives the relative percentage of each WBCAbsolute value gives the actual number of each WBC/mm3 of blood Calculation: absolute count= Total WBC x

percent

How to diffrentiate between LEUCOCYTOSIS and LEUCOPENIA

Quantitative changes (LEUCOCYTOSIS)

Leucocytes Phagocytes

Granulocytes Neutrophils Eosinophils BasophilsAgranulocytes

Mononuclear phagocytic cells Monocytes

Lymphocytes B-cells T-cells

LEUCOCYTES BENIGN DISORDERS Quantitative changes

(LEUCOCYTOSIS) increase WBCs count more than normal range

decrease TWBC lower than the normal range for the ,the body more susceptible to infection

(LEUCOPENIA)Normal range (adult)

4.5 -- 11.0 x 109/L

Definition:

LEUCOCYTES BENIGN DISORDERS Quantitative changes (contd.)

GranulocytosisIncrease in the count of all or one of the granulocytic component

Neutrophils Basophils Eosinophils

AgranulocytosisDecrease in the count of all or one granulocytic component

LEUCOCYTES BENIGN DISORDERS Quantitative changes (NEUTROPHILIA)

Definition Increase in the number of neutrophils and / or its precursors In adults count >7.5 x 109/L

Causes of NeutrophiliaInfection

BacterialInflammatory conditions

Autoimmune disorders

Marrow infiltration/fibrosisMyeloproliferative disorders

Quantitative changes (NEUTROPENIA)

Neutropenia is a decrease in Neutrophils absolute count.

Causes of NeutropeniaDrugs(chemotherapy of cancer patients)Irradiation exposureHyperslplenism

LEUCOCYTES BENIGN DISORDERS Quantitative changes (NEUTROPENIA) contd.

Causes of Neutropenia Drugs Irradiation exposure Immune disorders

HIV Neonatal i and autoimmune neutropenia

Hyperslplenism

Quantitative changes (EOSINOPHILIA)

Increase in the eosinophil count mustThe causes of eosinophilia

Allergy Atopic, drug sensitivity and pulmonary eosinophilia

Infection Parasites,

Malignancy Hodgkin’s disease, myeloproliferative disorders

Drugs

LEUCOCYTES BENIGN DISORDERS Quantitative changes (MONOCYTOSIS)

Increase in Absolute monocytes count

Causes of monocytosis Infections

Chronic infection (TB, typhoid fever) Malignant disease Connective tissue disorders

Ulcerative colitis, Sarcoidosis, Crohn’s disease

Quantitative changes (LYMPHOCYTOSIS)

Causes of LYMPHOCYTOSIS Infections

Viral infections

Increase in Absolute lymphocyte count

LEUCOCYTES BENIGN DISORDERS Qualitative changes ( structure )

Congenital Pelger-Huet anomaly

Bilobed and occasional unsegmented neutrophils Autosomal recessive disorder

LEUCOCYTES BENIGN DISORDERS Qualitative changes (MORPHOLOGY) contd.

Neutrophil hyper-segmentation Rare autosomal dominant condition Neutrophil function is essentially normal

May-Hegglin anomaly Neutrophils contain basophilic inclusions of

RNA Occasionally there is associated leucopenia Thrombocytopenia and giant platelet are

frequent

LEUCOCYTES BENIGN DISORDERS Qualitative changes (MORPHOLOGY) contd.

Alder’s anomaly Granulocytes, monocytes and lymphocytes

contain granules which stain purple with Romanowsky stain

Granules contain mucopolysaccharides

LEUCOCYTES BENIGN DISORDERS Qualitative changes (MORPHOLOGY) contd.

Chediak-Higashi syndrome Autosomal recessive disorder Giant granules in granulocytes, monocytes and

lymphocytes Partial occulocutaneous albinism Depressed migration and degranulation Recurrent pyogenic infections Lymphoproliferative syndrome may develop Treatment is BMT

LEUCOCYTES BENIGN DISORDERS Qualitative changes (MORPHOLOGY) contd.

Acquired Toxic granulation Dohle bodies Pelger cells Hypersegmented neutrophils

LEUCOCYTES BENIGN DISORDERS Qualitative changes (FUNCTIONAL)

Leucocyte adhesion deficiencyChronic granulomatous diseaseChediak-Higashi syndromePrimary immunodeficiency

Severe combined immunodeficiency Common variable immunodeficiency Isolated IgA deficiency T-cell immunodeficiency Thymic aplasia (Di George syndrome)