Lymphocytes Flashcards
Lymphocyte kinetics
Live a very long time and are able to divide and can recirculate from blood to lymph nodes and other lymphoid organs. Should not see plasma cells in blood in health
3 major causes of lymphocytosis
-Chronic inflammation
-Physiologic lymphocytosis (catecholamines)
-Lymphoid neoplasia
Chronic inflammatory lymphocytosis
Hyperplastic lymphoid response due to chronic antigenic or cytokine stimulation. Increased production causes them to leave LN and enter blood
Typical concurrent leukogram abnormalities with chronic inflammation
-Neutrophilia
-Monocytosis
-Sometimes eosinophilia or basophilia
Reactive lymphocytes
Immune stimulated lymphocytes.
Morphology of reactive lymphocytes
-Cytoplasmic basophilia
-Irregular shaped or cleaved nucleus
Scant basophilic cytoplasm
-Larger than naive lymphocytes
Physiologic lymphocytosis
Catecholamine release causes a shift from the marginating to circulating pool. No reactive lymphs
Lymphoid neoplasia lymphocytosis
From leukemia or Stage V lymphoma (can be in any tissue) see atypical or large lymphs. Can be due to increased production of neoplastic lymphocytes in the marrow, LN, or any soft tissue
Major causes of lymphopenia
-Acute inflammation
-Corticosteroids
Acute inflammatory lymphopenia
Increased migration to tissues and homing of lymphs to LN, less circulating in the blood now and decreased migration from LN to blood (minor)
Steroid lymphopenia
Decreased efflux of lymphs into blood and circulating pool shift to marrow and LN. High dose steroids have cytotoxic effects of lymphs in LN. Decreased lymphopoiesis as well
Stress leukogram
Mature neutrophilia
Lymphpenia
+/- monocytosis or eosinopenia
