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Benign LeukocytosesKristine Krafts, M.D.
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• Neutrophilia
• Lymphocytosis
• Basophilia
• Monocytosis
• Eosinophilia
Benign Leukocytoses
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• Neutrophils fight infection, participate in inflammatory responses
• Bone marrow• Most neutrophils live here• All stages of maturation
• Blood• Only 5% of all neutrophils are here• Normally only segmented neutrophils• Half are marginated
Neutrophilia
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• Mature (lots of segmented neutrophils)
• Immature (lots of immature neutrophils)
Types of Neutrophilia
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Mature neutrophilia
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Immature neutrophilia
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• Infection (bacterial)
• Inflammation
• Physiologic things• Stress• Hormones
Causes of Mature Neutrophilia
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• Seen only in infection!
• Toxic granulation, Döhle bodies, cytoplasmic vacuolization
• Scariest: cytoplasmic vacuolization
Toxic Changes
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Normal neutrophil(top left)
Neutrophil with toxic granulation
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Promyelocyte
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Döhle bodies
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Cytoplasmic vacuolization
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• Infection (bacterial)
• Inflammation
• Severe anemia
• Something filling up the marrow
Causes of Immature Neutrophilia
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• Left shift
Three Forms of Immature Neutrophilia
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blast promyelocyte myelocyte band segmented neutrophilmetamyelocyte
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Left shift
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• Left shift
• Leukemoid reaction
Three Forms of Immature Neutrophilia
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• Left shift
• Leukemoid reaction
• Leukoerythroblastotic reaction
Three Forms of Immature Neutrophilia
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Leukoerythroblastotic reaction
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• Left shift
• Leukemoid reaction
• Leukoerythroblastotic reaction• Due to something malignant• Due to something benign
Three Forms of Immature Neutrophilia
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• Lymphocytes fight infection, participate in immunologic responses
• Normal lymphocyte count• Varies a lot with age!• Bigger normal range in infants
• Normal immunophenotype in blood• T cells: 80%• B cells: 15%• NK cells: 5%
Lymphocytosis
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• Mature (lots of mature lymphocytes)
• Reactive (lots of funny-looking lymphocytes)
Types of Lymphocytosis
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Mature lymphocytosis
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Reactive lymphocytosis
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• Infectious lymphocytosis
• Bordetella pertussis
• Transient stress
Causes of Mature Lymphocytosis
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• Infectious mononucleosis
• Pediatric viral infections
• Viral hepatitis
• Immune disorders
Causes of Reactive Lymphocytosis
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Downey cells
IIIIII
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• Basophilia• CML• CML• CML
Other Benign Leukocytoses
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•Basophilia
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• Basophilia
• Eosinophilia• Drugs• Asthma• Skin diseases• Parasites
Other Benign Leukocytoses
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•Eosinophilia
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• Basophilia
• Eosinophilia
• Monocytosis• Infection• Autoimmune disease• Malignancy
Other Benign Leukocytoses
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•Monocytosis
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