leucocytes Benign Disorders Nada Mohamed Ahmed , MD, MT (ASCP)i

Contents. Quantitative Qualitative Definitions Classification Benign WBCs disorders Quantitative Change in number Qualitative Change in (function & structure)

LEUCOCYTES BENIGN DISORDERS Terminology Cytosis / philia Increase in number Cytopenia Decrease in number

How to diffrentiate between LEUCOCYTOSIS and LEUCOPENIA Relative vs Absolute values Total white blood cell count Differential count Absolute count Differential gives the relative percentage of each WBC Absolute value gives the actual number of each WBC/mm3 of blood Calculation: absolute count= Total WBC x percent

Quantitative changes (LEUCOCYTOSIS) Leucocytes Phagocytes Granulocytes Neutrophils Eosinophils Basophils Agranulocytes Mononuclear phagocytic cells Monocytes Lymphocytes B-cells T-cells

LEUCOCYTES BENIGN DISORDERS Quantitative changes Definition: (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

LEUCOCYTES BENIGN DISORDERS Quantitative changes (contd.) Granulocytosis Increase in the count of all or one of the granulocytic component Neutrophils Basophils Eosinophils Agranulocytosis Decrease 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 Neutrophilia Infection Bacterial Inflammatory conditions Autoimmune disorders Marrow infiltration/fibrosis Myeloproliferative disorders

Quantitative changes (NEUTROPENIA) Neutropenia is a decrease in Neutrophils absolute count. Causes of Neutropenia Drugs(chemotherapy of cancer patients) Irradiation exposure Hyperslplenism

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 must The 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) Increase in Absolute lymphocyte count Causes of LYMPHOCYTOSIS Infections Viral infections

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 deficiency Chronic granulomatous disease Chediak-Higashi syndrome Primary immunodeficiency Severe combined immunodeficiency Common variable immunodeficiency Isolated IgA deficiency T-cell immunodeficiency Thymic aplasia (Di George syndrome)