Leukocytes
General
l. Describe the purpose of leukocytes and list the different types of leukocytes present in the blood. Review CD antigens that may help in their identification. (Robbins 5th Ed., p. 631-632, Table 14-1) or (Robbins 6th Ed., p. 602-604, 645-646, Table 15-3)
Leukopenia (Robbins 5th Ed., p. 630 - 631) or (Robbins 6th Ed., p. 602-604)
1. Define leukopenia.
2. Define neutropenia and agranulocytosis. What are the causes of neutropenia?
3. What are the two major mechanisms of neutropenia?
4. List the clinical manifestation of neutropenia.
Leukocytosis: (Robbins 5th Ed., p. 631 - 632) or (6th Ed., p. 647-648), and Hematopathology case study folder case #4)
1. List the major causes of leukocytosis affecting neutrophils, eosinophils, lymphocytes, and monocytes.
2. Understand the usage of the term neutrophilic leukocytosis and leukemoid reaction. How is leukemoid reaction distinguished from chronic myelogenous leukemia?
3. Compare and contrast the morphologic features of atypical lymphocytes vs monocytes and atypical lymphocytes vs lymphoblasts. (Information in case study folder.)
Infectious mononucleosis (Robbins 5th Ed., p. 347 - 349) or (Robbins 6th Ed., p. 371-373)
1. List the major clinical features of infectious mononucleosis.
2. Describe the typical peripheral blood findings. What are atypical lymphocytes?
3. What is the pathogenesis of infectious mononucleosis?
4. How does one make a serologic diagnosis?
Lymphadenitis (Robbins 5th Ed., p. 632 - 633) or (6th Ed., p. 649-654)
1. Understand the meaning of the terms follicular hyperplasia, paracortical hyperplasia, and sinus histiocytosis, and relate them to the nature of lymphocytes involved in reactive inflammation.
1. (Robbins 5th Ed., p. 347-349, 630-633, Table 14-1) or (6th Ed., p. 371-373, 602-604, 645-650)
2. Image 1 is related to this case; the rest are related to other objectives
The patient is a 55-year-old white male who presents to the emergency room complaining of chest pain and labored breathing. His temperature is 98.6° F. He is overweight and smokes two packs of cigarettes a day. His EKG and cardiac enzyme profile reveal changes compatible with an acute myocardial infarction. The complete blood count (CBC) shows:
|
Hemoglobin (Hb) |
13 gm/dl (reference range 12 - 15.2 gm/dL) |
|
Total white blood cell |
15,500/mm3 |
|
Platelets (Plt) |
250,000/mm3 |
A differential white cell count was included in the CBC report, showing 80% segmented neutrophils (polymorphonuclear neutrophils), 10% "band" neutrophils, 7% lymphocytes, and 3% atypical lymphocytes. Based on the reported neutrophilic leukocytosis and "bandemia," an extensive infectious disease work-up was initiated.
This decision was confusing to you so you went to the laboratory and performed a 100-cell differential (white cell) count of the peripheral blood smear. The numbers you obtained basically agree with the original report except that you counted only 6% "bands" and you identified a myelocyte and a basophil.