WBC Differential Presentation

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    WBC DifferentialBy Jillian Giguere

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    How Is It Used?

    assesses the ability of the body to respond toand eliminate infection

    detects the severity of allergic and drug

    reactions detects response to parasitic and other types of

    infection.

    used in evaluating the reaction to viral infections

    and response to chemotherapy used to identify various stages of leukemia

    assess platelet numbers and RBC morphology

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    When is it ordered?

    Run as part of the CBC

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    Differential Count

    Examination of the leukocytes and

    classification of cells into different types

    Used to diagnose and monitor thetreatment of leukemias, anemias, and

    other diseases

    Record how many of each of the five types

    ofWBCs seen

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    Normally we count 100WBC's, the normalor reference ranges are approx.

    Neutrophils----------- 60%

    Lymphocytes--------25%

    Monocytes------------11%

    Eosophils--------------3%

    Basophils--------------1 %

    NNeverLet Monkeys Eat Bananas

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    APPEARANCE circular

    light-grey to pink cytoplasm

    diameter: ~14m

    granules are very fine and range incolorfrom reddish-violet to brown

    nucleus is bent and oblong partly with

    constrictions which have not yet resulted in

    filament

    NORMALRANGE Between 1.6 and 7.4 x 109/L

    FUNCTION

    defense against bacterial infections by

    phagocytizing the pathogens and killing them

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    Clinical Significance

    neutrophilia

    neutropenia under 0.5 x 109/L, severe neutropenia

    is present. This condition can be life

    threatening since it can lead to severeinfections.

    The neutrophil count usually is between 1.6 and 7.4 x 109/L

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    APPEARANCE

    round slightly larger than neutrophil

    granulocytes

    diameter: 16 m

    granules are coarse, bright red to honey-

    yellow and very densely packed

    nucleus is usually bilobed

    NORMALRANGERarely found in blood film

    Between 0.02 and 0.4 x 109/L

    FUNCTION

    role is not completely clear

    play an important role in allergic diseases, as

    well as in parasitic infections

    capable of phagocytosis and migration

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    eosinophilia

    eosinopenia

    Clinical SignificanceThe eosinophil count usually is between 0.02 and 0.4 x 109/L

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    APPEARANCE

    diameter: 10 to 14m smaller than theother granulocytes

    granules are coarse, dark violet, tightly

    packed and extensively overlay the nucleus

    and cytoplasm

    NORMALRANGERarely found in blood film

    Between 0 to 0.15 x 109/L

    FUNCTION

    P

    lay an important role in hypersensitivityreaction

    Able to leave the bloodstream and to

    emigrate to the surrounding tissue

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    basophilia

    Clinical SignificanceThe basophil count usually is between 0 and 0.15 x 109/L

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    monocytosis

    monocytopenia

    Clinical SignificanceThe monocytes count usually is between 0.2 and 1.0 x 109/L

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    APPEARANCE

    round to oval nucleus approximately the size of erythrocytes

    cytoplasm is grey-blue

    cell size varies between 9 and 20m

    large and small lymphocytes aredistinguished by the volume ofcytoplasm

    difference in size is an expression of

    different states of activation

    NORMALRANGEBetween 1.0 and 3.5 x 109/L

    Second most frequent leukocyte in the

    blood film after neutrophilic granulocytes

    FUNCTION participate in cellular and humoral

    defense against infection

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    have large volume ofcytoplasm with clear azure granules

    constitute 5-10% of all lymphocytes

    correspond to either a subpopulation of T-cells or natural killercells

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    lymphocytosis

    lymphopenia

    Clinical SignificanceThe lymphocytes count usually is between 1.0 and 3.5 x 109/L

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    APPEARANCE

    rarely found in peripheral blood diameter: 15 to 20m, they are larger than

    lymphocytes

    features include an eccentric nuclei and

    perinuclear halo

    NORMALRANGEBetween 0 and 0.1 x 109/L

    Rarely found in the blood film

    FUNCTION

    produce antibodies for defense against

    infection

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    http://www.getbodysmart.com/ap2/circulatorysystem/blood/wbcs/wbcdifferential/tutorial.html

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    1. Prepare blood smear on slide.

    2. Dip slide in stain for 10 seconds.

    3. Dip slide in distilled water (pH 6-7) for 20 seconds (or more for darker staining).4. Air dry.

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    1. segmented (mature) neutrophil

    2. band (immature) neutrophil

    3. eosinophil

    4. basophil

    5. lymphocyte

    6. monocyte

    7. neutrophil

    8. eosinophil

    9. basophil

    10. small lymphocyte

    11. large lymphocytes

    12. neutrophil

    13. monocyte

    14. eosinophil

    15. monocyte

    16. eosinophil

    17. basophil