Haematology WBC-1

8/4/2019 Haematology WBC-1

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LeukocytesWhite Blood Cells


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Formation of WBCs

Leukocytes are formed in the redmarrow of many bones.

They can also be formed in lymphatictissue.

They live for about 13-20 days.


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Myelocytic

Maturation SeriesMyeloblast

PromyelocyteMyelocyte

Metamyelocyte

Band Neutrophil

Segmented Neutrophil


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Myelopoeisis

HSC: hemopoeitic stem cell, HPG: hemopoeitic progenitor cells,

CMP: committed myeloid progenitor cell, CLP: committed lymphoidprogenitor cells, CFU: colony forming unit


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White Blood Cells


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WBC Numbers Doctors look at WBC numbers. If number goes up there is some kind

of infection .

Clinics will count the number ofWBCs in a blood sample, this iscalled differential count.

A decrease in the number of white

blood cells is leukopenia. An increase in the number of white

blood cells is leukocytosis.


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White Blood Cells

Per l blood Per l of blood

Total WBC count 5,000 10,000

Neutrophils 50 - 70% 2,000 7,000

Lymphocytes 20 - 40% 1,000 4,000

Monocytes 1 6% 50 600

Eosinophils 1 5% 50 500

Basophils 0 2% 0 - 100


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WBCs Five Types Classified according to the presence

or absence of granules and the

staining characteristics of theircytoplasm.

Leukocytes appear brightly coloredin stained preparations, they have anuclei and are generally larger insize than RBCs.


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Type of WBCs

Granulocyteshave largegranules in their cytoplasm

Neutrophils

EosinophilsBasophils


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Granulocytes Eosinophils

Large, numerous granules

Nuclei with two lobes

2-5% of WBC count

Found in lining of respiratory and digestivetracts

Important functions involve protectionsagainst infections caused by parasitic worms

and involvement in allergic reactions Secrete anti-inflammatory substances in

allergic reactions


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Granulocytes

Basophils

Least numerous--.5-1%

DiapedesisCan leave blood vesselsand enter tissue space

Contain histamineinflammatory

chemical


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Granuloctyes

Neutrophils Stain light purple with neutral dyes

Granules are small and numerouscourse appearance

Several lobes in nucleus 65% of WBC count

Highly mobile/very active

Diapedesis

Can leave blood vesselsand enter tissue space

Phagocytosis (eater), contain severallysosomes


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Types of WBCs

Agranulocytesdo not havegranules in their cytoplasm

Lymphocytes

Monocytes


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Agranulocytes Lymphocytes

Smallest WBC

Large nuclei/small amount of

cytoplasm Account for 25% of WBC count

Two typesT lymphocytesattackan infect or cancerous cell, B

lymphocytesproduce antibodiesagainst specific antigens (foreignbody)


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Agranulocytes

Monocytes

Largest of WBCs

Dark kidney bean shaped nuclei Highly phagocytic


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White blood cells disorders

I. Leukocytosis

increased number of leucocytic countabove upper range of

normal(11,000/mm3 in adult).


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Neutrophilia Neutrophils > 7.5 x 109/L

1. Acute pyogenic infection2. Tissue damage: Truma or infarction3. Malignancy

4. Myeloproliferative disorders : CML5. Drugs: digitalis, Cortison. Myeloproliferative

disorders (CML)


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NEUTROPHILIA


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Eosinphilia Eosinphils > 4 x109/L ( 0.04- 0.4

X109/L). Causes:

1. Allergic diseases2. parasitic diseases

3. Recovery from acuteinfection4. certain skin diseases5. Drug sensitivity


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Basophilia

Basophils > 0.1 x 109/L(N: o.o1-o.1x109/L).

Causes:Myeloproliferativedisorders (MPD)e.g.CML.


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Moncytosis Monocytes > 0.8x 109/L (N:

0.2-0.8x109

/LCauses: Causes:

Chronic bacterial infectione.g. brucllosis, typhoid.


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Lymphocytosis

RelativeLymphocytosis:

PMN leucocytes aredecreased, so the

lymphocytes arerelatively increased.


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Causes:

1. Viral infection

CMVMeasels

2. Bacterial infection

PertusisBrucellosis

3. Chronic lymphocytic leukemia

4. Lymphoma


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Leucopenia

Decrease in leucocytic count below4000/mm

I. neutropenia:


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2. Infection:

Viral: Hepatitis, HIV

Bacterial: brucellosis

some fungal infections


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Agranulocytosis

Marked reduction of neutrophilsbelow 500/mm.


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Lymphopenia

Lymphocytes


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Infectious Mononucleosis Caused by EBV

Clinical picture: sorethroat, fever,Lymphadenopathy splenomegaly.

Laboratory findings:

Absolute lymphocytosiswith atypical

lymphocytes.


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Neoplastic Proliferation of White Cells

Leukemia

Malignant neoplasm of the

hematopoietic stem cells BM replaced by unregulated,

proliferating, immature neoplastic

cells blood leukemia enterspleen, lymph nodes


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Neoplastic Proliferation of White Cells

Classification of Leukemia

A. According to cell type and state of cellmaturity

Lymphocytic immature lymphocytes and theirprogenators

Myelocytic pluripotent myeloid stem cells andinterferes with maturation of all granulocytes, RBCand platelets

B. Acute or Chronic Acute immature cells (blast)

Chronic well differentiated leukocytes


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Classification of leukemias

Acute Chronic

Myeloidorigin

Lymphoidorigin

Acute MyeloidLeukemia (AML)

Acute LymphoblasticLeukemia (ALL)

Chronic Myeloid Leukemia(CML)

Chronic Lymphocytic Leukemia(CLL)

ALL


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Hematopoieticstem cell

Neutrophils

Eosinophils

Basophils

Monocytes

Platelets

Red cells

Myeloidprogenitor

Lymphoidprogenitor

B-lymphocytes

T-lymphocytes

Plasmacells

nave

ALL

AML


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Acute Leukemia


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Acute Lymphocytic Leukemia (ALL)

Most common leukemia in children(80%)

Treatable and potentially curable Classified according to lymphocytes

and state of maturations


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ALL


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Acute Myleocytic Leukemia (AML)

Acute Non-lymphocytic Leukemia (ANLL)

Most common in adults; >50% 60years old


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Acute Myeloid Leukemia

accumulation of blasts in the marrow

A d i AML


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Auer rods in AML


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Chronic Leukemia


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Classification of CL.

There are two types:

1-chronic myeloid leukemia.

2-chronic lymphoid leukemia.


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Chronic Myeloid Leukemia.


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Definition of CML:

Is a clonal disorder of a pluripotentstem cell and is classified as one ofthe myeloproliferative disorder.


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CML


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CML


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Chronic lymphocytic

Leukemia:

CLL


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CLL


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Splenomegaly & hepatomegaly


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Investigation:

CBC:

Wbc:

Diff:lymphocytosis

Anemia:normocytic normochromic anemia Platelets : thrombocytepenia may occur.


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Good Luck!..

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Haematology WBC-1