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Characteristically have a
multi-lobed nucleus and very fine, neutral-stained cytoplasmic granules.
Decreased: 2,000 /mm3
Acute Bacterial infection
With quite large, regular, refractile, eosinophilic (pink) cytoplasmic granules, and a bilobed nucleus.
Normal : 0-7 % Absolute count: 0.0-0.7 K/mm3
- Allergic disease
- Parasitic infections
- Aminosalicylic acid
- PIE syndrome
- Collagen vascular disease
- Malignant neoplasm's
- Hypereosinophilic syndromes
- Bacterial infection
With very dark, coarse, basophilic
(purple-blue) granules in the cytoplasm surrounding the lobed nucleus.
The largest of the leukocytes, it
has quite a bit of bluish cytoplasm, surrounding a typically kidney-bean-shaped nucleus.
Only a little larger than a red
blood cell, it has only a thin rim of pale cytoplasm around a darkly stained round
nucleus. A large lymphocyte circulating in the blood. The nucleus is characteristically
round and dark, but there is more cytoplasm than in the typical "small" blood
|Increased: >4,000/mm3||Decreased : 1000/mm3|
Peripheral smear with abnormal cells
Plasma cells: (Rarely seen in normal peripheral smear)
- Multiple myeloma
- Plasma cell leukemia
Abundant finely granular, basophilic cytoplasm containing small fenestration's
- Caused by Epstein-Barr Virus
- Total white blood cell count may be increased up to 18,000/microliter
- 95% atypical t-cell lymphocytes
- With abundant finely granular, basophilic cytoplasm containing small fenestration's
Acute Myelogenous Leukemia (AML):
- Cancerous transformation of multipotent myeloid stem cells associated with many different cytogenetic abnormalities and gene findings, with increased myeloblasts in peripheral smear and marrow
- Peripheral smear: Immature white cells called blasts that are larger than those in ALL and have a lower nuclear /cytoplasmic ratio
- Cytoplasm may stain for enzymatic markers such as peroxidase or esterase and may contain auer rods (abnormal primary granules)
- High blast production may cause pancytopenia by feedback suppression leading to decreased white blood cells, red blood cells, and platelets.
Acute Lymphocytic Leukemia:
- 80% of B cell origin; 20% of T cell origin
- The nuclei of leukemic blasts in Wright-Giemsa stained preparations have somewhat course and clumped chromatin and 1-2 nucleoli
- Unlike AML blasts, the cytoplasm of these blasts do not contain azurophilic granules (auer rods) or cytochemical peroxidase
- Cytoplasm of these blasts often have large aggregates of PAS material
Chronic Myelogenous Leukemia (CML):
- Disorder of pluripotent stem cells with a specific cytogenetic abnormality, t(9;21), and genetic finding of BCR/ABL fusion gene,that results in abnormal differentiation along granulocytic pathways
- Increased leukocyte count; usually >100,000 / mm3
- Primarily neutrophils and metamyelocytes but may have prominent basophils and Eosinophils, also.
- Small number of myeloblasts may also be present in peripheral smear Ø 50% have thrombocytosis also early in disease
- Different from leukomoid reaction b/c almost total lack of alkaline phosphatase in granulocytes Eventually all patients transform to an aggressive acute leukemia
Chronic Lymphocytic Leukemia (CLL):
- Neoplasm of CD5 positive B cells (a rare normal B cell phenotype). CLL cells do not mature normally and fail to undergo apoptosis
- Absolute Lymphocytosis with small mature looking lymphocytes
- May develop autoantibodies to red blood cells and platelets causing hemolytic anemia and thrombocytopenia
- Leukocyte count may be slightly or markedly increased
Hairy cell Leukemia
Plama cell leukemia:
Resembling but not Leukemia
Either increase in magnitude of Leukocytosis or Blast cells
- Disseminated TB
- Gastric, Breast, Lung cancers