1. Leukocytosis - Peripheral Blood
A low magnification view (4x) of the peripheral blood smear permits
you to estimate the total white blood cell count (TWBC), which in
this case was reported to be 15 x10^3/ml. [Note: a rule of thumb
for assessing the TWBC: 15 to 20 WBC/4x field correlates with a TWBC
of approximately 15 - 20x10^3/ml]. At a slightly higher
magnification (10x), review of the smear now reveals that most of the
leukocytes are granulocytes, specifically neutrophils. A superficial
examination of these neutrophils reveals that some are fully
segmented while others are "band" forms. A higher magnification
(100x) reveals a segmented neutrophil demonstrating the typical thin
chromatin strand connecting the lobes (segmented neutrophil -3a). In
addition, the smear shows a typical "band" form with a horseshoe
nucleus and no thin chromatin strands ("band" neutrophil -3b).
Although the distinction between these two cells is clear in this
picture, such is not always the case. 1. What findings in the CBC
report prompted an infectious disease work-up?
Answer
2. Compare and contrast neutrophilic leukocytosis, leukemoid
reaction, chronic myelogenous leukemia, and acute myeloblastic
leukemia.
Answer
