WBC Disorders

Erwin Taher
Medical Faculty
Dept of Clinical Pathology
UISU
 Normal
Pathology
White cell disorders

Non neoplastic Abnormalities

in # - Penias & - Philias
Neoplastic disorders
Premalignant conditions
Myelodysplastic syndromes
Myeloproliferative disorders
Malignant or Leukemias
Acute & Chronic
Myeloid & Lymphoid
Hairy cell leukemia
Plasma cell neoplasms
 Lymph node disorders
Non neoplastic or Inflammatory

Acute Lymphadenitis

Chronic Lymphadenitis

Neoplastic or Lymphomas

Hodgkins lymphoma

Non- Hodgkins Lymphoma

Miscellaneous
Langerhans cell Histiocytosis

Splenic disorders

Disorders of thymus
 Total Leukocyte count
Differential Leukocyte
count
Basic functions of
Leukocytes
WBC - CBC
WBC :Non neoplastic Abnormalities

Penias (Leukopenia)
Neutropenia is most common and important
low circulating neutrophil count

<1500 cell/cu. mm Neutropenia

1000 cells/ cu. mm worrisome

500 cells/ cu. mm - serious infections

100 cells/ cu. mm - life threatening ( also called

agranulocytosis)
WBC :Non neoplastic Abnormalities
Penias (Neutropenia)
Causes
or ineffective production

Aplastic anemia
Drugs
Disorders Vit. deficiencies ( B12, Folate)
Myelodysplastic syndromes
Inherited disorder kostmann syndrome (defective
genes of granulocyte differentiation)
removal from circulation
Immunological SLE, Drugs
Hypersplenism
utilization infections ( mainly Bacterial)
WBC :Non neoplastic Abnormalities

Neutropenia
Most significant cause Drugs

May dose related or Idiosyncratic

Act by marrow suppression (chlorpromazine) or

immunological (sulfa & Thiouracil)
Morphology = marrow changes depend on underlying cause
Hyperplasia of marrow if the cause is peripheral destruction

or ineffective poiesis
Hypoplasia if it is due to Myelo- suppression
WBC :Non neoplastic Abnormalities
Leukocytosis
Leukocytosis Philias ( Example Neutrophilia)
Pathogenesis
Precursor pool storage pool peripheral blood
(Margination & circulating) Tissue pool
Mechanisms
For Neutrophils
***Mostly from marrow storage pool immediate
Granulocytopoiesis from stimulation of marrow stem
cells by inflammatory mediators (IL-1, TNF)
For Eosinophils- IL-5

For Lympho IL-7

WBC :Non neoplastic Abnormalities
Leukocytosis - Neutrophilia
WBC :Non neoplastic Abnormalities
Leukocytosis
Morphology
# neutrophils &Toxic granulations ( abnormal azuriphilic

granules), Dhole bodies (Endoplasmic Reticulum) like in

Kawasakis disease)
Differential Diagnosis
Leukemoid reaction (inflammation) from leukemia
WBC :Non neoplastic Abnormalities
Leukocytosis -Toxic Granulation:
WBC :Non neoplastic Abnormalities
Leukocytosis - causes
Neutrophilic Acute bacterial infections( pyogenic)
leukocytosis
Eosinophilic Allergic disorders such as asthma, hay fever, allergic
leukocytosis skin diseases parasitic infestations; drug
(eosinophilia) reactions; certain malignancies (e.g., Hodgkin
disease and some non-Hodgkin lymphomas);
Basophilic leukocytosis Rare, indicative of CML
(Basophilia)
Monocytosis Chronic infections (TB, SLE) inflammatory bowel
diseases (ulcerative colitis)
Lymphocytosis Accompanies monocytosis in many disorders viral
infections (e.g., hepatitis A, cytomegalovirus,
Epstein-Barr virus); Bordetella pertussis infection
WBC :Non neoplastic Abnormalities
Leukocytosis -Lymphocytosis