Abnormal Leukon: Neutrophilia (Balasz) Flashcards
(55 cards)
What may cause hypersegmented neutrophilia? What effect may this have on counts?
Steroids prevent adhesion of neutrophils to wall
- less cells enter tissues and marginate
- neutrophilia results
“steroid neutrophilia”
What is a physiological casue of neutrophilia?
Being scared ^ BP washes marginaed neutrophils off
What causes neutrophilia?
- infections (bacterial, viral, protozoal)
- immune mediated dz (IMHA, polyarthritis)
- 2* to neoplasia
- haemolysis, haemorrhage, necorsis, thrombosis
> acute/chronic inflam leukogram, steroid, physiological shift, chronic myeloid leukaemia
What is the most common type of leukaemia?
- lymphoid
What is the difference ebetween chronic and acute leukaemia?
> chronic =
- well differentiated neutrophils transformed: chronic granulocytic leukaemia
- numbers can be v high, r/o other casues of increase
acute =
- poorly differentiated (early precursor) transformed: acute myeloid leukaemia
- porg v poor
eg. Neutrophilia d/t increased persistence in the circulation?
> stress/steroid response(neutrophils remain in circulation longer)
- may be hypersegmeneted
- accompanied by monocytosis and lymphopenia (other steroid effects)
Egs. Neutrophilia d/t Redistribution. Other changes seen concurrently?
- stress/excitement ^ BP
- marginated neutrophils not normally sampled swept into circulation
- may ^ WBC >200% cats
- lymphocytes prevented from leaving circulation and mobilised from thoracic duct so numbers also increase
Tx of neutrophilia?
Tx the patient!
- tx underlying cause
Px chronic granulocytic leukaemia?
- good short term
Px acute myeloid leukaemia?
- no successful tx
Normal description of a mature lymphocyte?
Small, round ,very small amount blue cytoplasma, nucleus massive and about the same size as RBC
How do B and T lymphocytes differ? Where are they formed and where do they circulate?
- look the same
- formed in BM but production and clonal proliferation in thymus, spleen LNs
- travel blood - tissues - lymphatics - in and out of lymphoid tissue - blood
> B cells - short lived (d/weeks) except memory cells
> T cells - long lived months/years
Are lymphoctes commonly looked at when assessing BM function?
No!
Reactive changes of lymphocytres seen micrscopically?
- ^ cytoplasm, dark blue
- indentation of nucleus
- vauloated/dotty cytoplasma (constipated plasma cell)
Causes of lymphopenia?
- acute inflammatory
- stay in tissues
- stay in LNs - steroid lymphopenia
- egression into LNs and BM
- destroys LNs - depletion lymphopenia
- chylous effusion - lymphoid hypoplasia or aplasia
Causes of lymphopenia d/t ^ demand
- PLE (loss of lymphocyte rich chyle)
- chylothorax/peritoneum if drained
- recruitment and emigration into tissue with some antigens
Causes of lymphopenia d/t redistribution?
- steroids (exo/endo) stress
> redistribution into BM, tissues and trapping in LN - trapping in lymph rich fluid (chylothorax etc.)
Causes of lymphopenia d/t v production?
> infectious
- virsuese (canine distemper, parvo, panleucopenia, FeLV, FIV)
lympholytic drugs
- chemo (eg. cyclophosphamide, azathioprine, long term steroids)
congential immunodeficiency
- eg. Bassett hound B and T cells affected
Causes of lymphocytosis?
- chonic inflammatory
- physiological (Shift)
= neutrophils ,will ^ circulating no. - lymphoproliferative
Which animals will have high unmbers of reactive lymphocytes?
young animals esp puppies
^ no. to ^ demand LOOK
- puppies can be higher than range of adult (normal!)
^ no indepednent of demand
> chronic lymphocytic leukaemia > acute lymphoiblastic leukaemia - v poor px, no tx - poorly differentiated - v. quick progressive aggressive dz > Stage V lymphoma (spleen, liver etc. involved aswell) - w/ BM involvement - release of neoplastic lymphocytes into circulation
Redistribution
> phyisological - inhibition of recirculation - release from thoracic duct > Hypoadrenocorticism - lymphocytosis even when stressed (which should cause lymphopenia) - d/t cortisol
How can a monocyte be identified
- larger than neutrophil
- blue grey cytoplasm
- +- cytoplasm can contain vacuoles (neutrophils dont)
- nucleus can look like anything!! lymphoid/nuetrophilic but is lighter than neutrophil nucleus
- can look like toxic neutrophils (bluer cytoplasm, vacuolated, giant neutrophils etc.)
