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Exam 2
Chapter 19: Non-Malignant Granulocytes and Monocytes
74
Science
Graduate
03/27/2013

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Term
Neutrophilia hematologic data
Definition
7 x 103/uL, or less than 7000 cells/uL
Term
Common disorders associated with neutrophilia
Definition
bacterial infection, severe infections, fungal, rickettsial, parasitic infections, viral infections (occasional), tissue destruction due to necrosis, inflammation (RA, Rheumatic fever, gout, nephritis, colitis, pancreatitis)
Term
Quantitative neutrophil response to acute bacterial infections
Definition
neutrophils can range from 7.0- 70 x 103/uL, usually between 10-25 x 103/uL
Term
Qualitative neutrophil response to acute bacterial infections
Definition
shift to the left due to increased flow of PMNs from BM storage pool to PB, young cells in PB
Term
Immature granulocytes associated with reactive neutrophilia
Definition
young cells, shift left, bands, metas, occasionally myelos
Term
Morphologic changes associated with reactive neutrophilia
Definition
toxic changes like toxic granulation, Döhle bodies and vacuolization
Term
Leukemoid reaction
Definition
extreme neutrophilic reaction to severe infections, necrotizing tissue characterized by benign leukocyte proliferation. See left shift and a white count below 50 x 103/uL
Term
Leukoerythroblastosis
Definition
associated with chronic neoplastic myeloproliferative disorder (myelofibrosis or myelophthisis), characterized by the presence of nRBCs and neutrophilic shift to the left, total neutrophil count can be increased or decreased or normal, RBC anisocytosis and poikilocytosis (teardrop cells)
Term
Pyknotic nuclei
Definition
characteristic of dying cells, nuclear chromatin condenses and becomes structure less and segments disappear becoming smooth, dark-staining spheres
Term
Leukemoid reaction v. CML
Definition
Leukemoid reaction is transient neutrophilia with a normal karyotype and elevated LAP scores and CML has the Philadelphia chromosomal mutation, decreased LAP scored and flow cytometry markers
Term
Neutropenia hematologic data
Definition
0.5- 1.8 x 103/uL
Term
Common disorders associated with neutropenia
Definition
infections, radiation, drugs, hematologic disorders, allo/auto antibodies, hereditary disorders
Term
Spurious neutropenia
Definition
EDTA induced neutrophil adherence to erythrocytes, disintegration of neutrophils over time prior to testing, disruption of abnormally fragile leukocytes during preparation of blood, neutrophil aggregation
Term
Pelger-Huet
Definition
decreased segmentation of nuclear of granulocytes with condensation of nuclear chromatin (monolobe = homo, bilobe = hetero), due to autosomal dominant inheritance
Term
Hypersegmentation
Definition
6 or more nuclear segments, seen in megaloblastic anemia and hereditary Hypersegmentation
Term
Pyknotic forms
Definition
condensed nuclear chromatin, seen in degenerating nuclei
Term
Morulae
Definition
seen in Erlichia intracellular organism infection, 2 dense basophilic inclusions in the granulocyte
Term
Alder-Reilly granules
Definition
large deep lilac granules in granulocytes, monocytes and lymphocytes
Term
Chediak-higashi inclusions
Definition
large, lysosome-like organelles in most granule containing cells (monos, lymphs and granulocytes), enormous azurophilic granule in PMN
Term
Conditions associated with abnormal Eosinophil count
Definition
infections with helminthic parasites, allergic diseases (increased) or increase in glucocorticoids and epinephrine (decreased)
Term
Conditions associated with abnormal Basophil count
Definition
Thyroid insufficiency, inflammatory reactions, CML, basophilic leukemia (increase) or leukocytosis with infection, inflammation or immunologic reactions (decrease)
Term
Conditions associated with abnormal monocyte count
Definition
stem cell disorders (aplastic anemia), glucocorticoids, fungi, mycobacteria or listeria infections in immunocomprimised people (decrease) or reactive monocytosis due to chronic infectious process (TB, bacterial endocarditis, syphilis, CMV), inflammatory or immune disorders (collagen, GI) or chronic neutropenic disorders (increase)
Term
Gaucher
Definition
AR disease in which there is a deficiency of glucocerebrosidase (enzyme) which causes lipid glucocerebroside to accumulate in macrophages (called gaucher cells)
Term
Niemann-Pick disease
Definition
AR disease in which there is a deficiency of sphingomyelinase (enzyme) which causes foamy macrophages
Term
Etiology acute neutrophilia
Definition
bacterial infection or toxin
Term
Associated conditions acute neutrophilia
Definition
increased flow of PMNs from BM storage pool to PB
Term
Peripheral blood findings for acute neutrophilia
Definition
shift to the left
Term
Etiology chronic neutrophilia
Definition
follows acute if stimulus persists
Term
follows acute if stimulus persists
Definition
left shift in cell population, increased production in mitotic pool
Term
Etiology reactive neutrophilia
Definition
follows chronic if stimulus persists
Term
Peripheral blood findings for reactive neutrophilia
Definition
total leukocytes < 50 x 103/uL, left shift, toxic changes, increased LAP score
Term
Hematologic features for Leukemoid reaction
Definition
neutrophilic reaction, WBC count > 50 x 103/uL, left shift with immature leukocytes (bands, metas and myelos), transient, elevated LAP
Term
Clinical features for Leukemoid reaction
Definition
severe infection or necrotizing tissue, benign leukocyte proliferation
Term
Hematologic features for CML
Definition
decreased LAP
Term
Clinical features for CML
Definition
FISH for Philadelphia chromosome, flow cytometry for cancer cell markers
Term
Etiology of neutropenia
Definition
severe infections can cause BM storage and mitotic pools to proliferate and they are not able to keep with demands
Term
Associated conditions of neutropenia
Definition
bacterial infections, myeloid hypoplasia, lack of cells at inflammatory sites, stem cell disorders
Term
Blood findings for neutropenia
Definition
~1.8 x 103/uL, monocytosis, eosinophilia
Term
Bone marrow findings for neutropenia
Definition
hyperplastic, decreased M:E ration, decrease in BM storage pool
Term
Spurious/false neutropenia
Definition
neutropenia as a result of laboratory in vitro manipulations of blood
Term
Evaluation of Spurious/false neutropenia
Definition
determine the causes and correct before differential can be due to (1) EDTA induced adherence to erythrocytes (2) disintegration of neutrophils over time (3) disruption of abnormally fragile leukocytes during preparation or (4) neutrophil aggregation
Term
Appropriate corrective action for Spurious/false neutropenia
Definition
Adherence is corrected by recollecting a finger stick without EDTA, disintegration is corrected by recollecting and testing at a faster time, disruption is corrected by being more careful and aggregation is corrected by removing paraproteins
Term
Pelger Huet Nuclear abnormalities
Definition
abnormal lobe development, decrease in segmentation of the nucleus of granulocytes with condensation of the nuclear chromatin
Term
Clinical conditions associated with Pelger Huet
Definition
inherited disorder,
Term
Pseudo-Pelger Huet nuclear abnormalities
Definition
hypogranulation because of lack of secondary granules, nuclei acquire a round shape rather than dumbbell shape, chromatin shows intense clumping
Term
Clinical conditions associated with Pseudo-Pelger Huet
Definition
Myeloid malignancies, myeloproliferative/myelodysplastic states
Term
Hypersegmentation nuclear abnormalities
Definition
six or more nuclear segments
Term
Clinical conditions associated with Hypersegmentation
Definition
megablastic anemias, hereditary Hypersegmentation
Term
Pyknotic nuclei nuclear abnormalities
Definition
nuclear chromatin condenses, becomes structure-less, segments disappear, become smooth, dark-staining spheres
Term
Clinical conditions associated with Pyknotic nuclei
Definition
dying neutrophils
Term
Toxic granulation
Definition
neutrophil primary granules strain more prominently than normal granules
Term
Clinical conditions associated with toxic granulation
Definition
severe infections, burns, cancer, toxic drugs
Term
Döhle bodies
Definition
stacks of rough endoplasmic reticulum stains light blue or gray, single or multiple within cells
Term
Clinical conditions associated with Döhle bodies
Definition
severe infections, burns, cancer, toxic drugs
Term
Vacuoles
Definition
clear, unstained areas in cytoplasm
Term
Clinical conditions associated with vacuoles
Definition
severe infections, burns, cancer, toxic drugs, artifact when stored with EDTA
Term
Intracellular organisms
Definition
seen in cytoplasm of white cells
Term
Clinical conditions associated with intracellular organisms
Definition
bacteria, histoplasmosis, Candida, Erlichia
Term
Morulae
Definition
observed on leukocytes, large, oval inclusions, more than one per cell
Term
Clinical conditions associated with morulae
Definition
intracellular micro colonies of Erlichia
Term
Clinical features of Chédiak-Higashi
Definition
oculocutaneous albinism, increase in susceptibility to infection, neutropenia, thrombocytopenia, lymphadenopathy, and decrease in dense body contents of platelets
Term
Cellular abnormalities of Chédiak-Higashi
Definition
large lysosome like organelles in all granule containing cells, PMNs has enormous abnormal azurophilic granules
Term
Clinical features of Alder-Reilly
Definition
metabolic disorder of polysaccharide metabolism
Term
Cellular abnormalities of Alder-Reilly
Definition
large, dense, deep, lilac granules in granulocytes, monos and lymphs
Term
Clinical features of May-Hegglin
Definition
leukopenia, giant platelets, mild thrombocytopenia
Term
Cellular abnormalities of May-Hegglin
Definition
large basophilic bodies in PMNs, eosinophils, basophils, and monocytes, made of RNA from rough ER which are larger and more round than Döhle bodies
Term
Alterations in relative/absolute numbers of eosinophils
Definition
can be reactive secondary eosinophilia, diurnal variation, or eosinopenia
Term
Clinical conditions associated with change in eosinophils
Definition
diurnal variation associated with neonates or exercise, lowest in AM, reactive secondary eosinophilia associated with infections with helminthic parasites and allergic disease, eosinopenia associated with increase in glucocorticoids and epinephrine
Term
Alterations in relative/absolute numbers of basophils
Definition
basophilia ( > 0.2 103/uL) or basopenia
Term
Clinical conditions associated with change in basophils
Definition
basophilia associated with thyroid insufficiency, inflammatory reactions, chronic myeloproliferative disease and basophilic leukemia, basopenia associated with leukocytosis with infection, inflammation or immunologic reactions
Term
Alterations in relative/absolute numbers of monocytes
Definition
monocytopenia ( < 0.2 x 109/L), monocytosis ( > 8.0 x 109/L)
Term
Clinical conditions associated with change in monocytes
Definition
monocytopenia associated with stem cell disorders, glucocorticoids and predisposition to infections with fungi, mycobacteria and listeria, monocytosis associated with chronic infectious processes, inflammatory and immune disorders and chronic neutropenic disorders
Term
Gaucher disease abnormal macrophages
Definition
lipid glucocerebroside accumulates in macrophages called gaucher cells which are large with small eccentric nuclei and a wrinkled or striated cytoplasm
Term
Niemann-pick disease abnormal macrophages
Definition
Niemann-pick disease abnormal macrophages
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