WBC disorders Non neoplastic by sammyc2007

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WBC - Disorders

Dr. Venkatesh M. Shashidhar
Senior Lecturer in Pathology Fiji School of Medicine

Normal Blood Film:

White Blood Cells:

CBC - WBC Histogram:

WBC disorders:
. Reactive increase in number – “philias”  Neutophilia – Bacterial sepsis  Lymphocytosis – viral infections  Eosinophilia – Allergy & Parasites. 2. Decreased production – “penias”  Neutropenia, Lymphopenia & Eosinopenia, Pancytopenia  Drugs, viral infections, Radiation, chemotherapy etc.

WBC Neoplastic disorders
Leukemias Bone marrow, blood, blast cells
Acute / Chronic & Myeloid / Lymphoid  AML / ALL & CML / CLL

Lymphomas – Lymph nodes, tumor
Hodgkins  Non-Hodgkins. Myeloma

Premalignant conditions:
Myeloproliferative syndromes (MPS)  Myelodysplastic syndromes (MDS)


Toxic Granulation:

Leukemoid Reaction:


Neoplastic disorders
Leukemias Lymphomas Premalignant conditions

Haematological Neoplasia:
Acute & Chronic  Myeloid & Lymphoid

Hodgkins & Non-Hodgkins  High grade & Low grade

Premalignant Conditions
Myeloproliferative syndromes (MPS)  Myelodysplastic syndromes (MDS)

Leukemia Classification
Acute Leukemias:

Acute Myeloid Leukemia - AML

AML M0 to M7 on maturity ALL - L1, L2 & L3 - maturity


Acute Lymphoid Leukemia - ALL

Chronic Leukemias:
Chronic Myeloid Leukemia- CML  Chronic Lymphoid Leukemia - CLL

Leukemia - Clinical Features
Anemia (low RBC) Fever - Infections (low WBC) Bleeding tendency (low PLT) Tender bones, lymphadenopathy, spleenomegaly etc. (Leukemic infiltration)


AML-M5 - Gum Hypertrophy:

ALL:Cervical Lymphadenopathy

Mediastinal Lymphadenopathy - ALL

ALL-Acute Lymphocytic Leuk.

Common in Children. FAB classification L1, L2 & L3 CD10 +ve, Pre B cell type common. Growth failure, Fever, Anemia Lymphadenopathy, bleeding. Moderate Hepatosplenomegaly


AML-Acute Myeloid Leuk.
Adults common FAB classification - M0 to M7. Anemia, Fever, Bleeding Hepatosplenomegaly moderate No significant lymphadenopathy

AML-M2 - with maturation

AML-M3 - Auer Rods

AML-M4 - Myelomonocytic

Chronic Myeloid Leukemia
Middle age 40-60y Philadelphia chromosome, t(9:22) Anemia, Fever & Bleeding Marked leucocytosis – >50,000 (abnormal) Marked splenomegaly, Hepatomegaly

Chronic Myeloid Leukemia:

Chronic Lymphocytic Leukemia
Elderly age Anemia, fever & bleeding – slow over years. Lymphocytosis & Lymphadenopathy Spleen, & liver enlargement Common B cell (CD5 +ve)


CLL – Blood Film


Tumors of lymphoid tissue Lymphadenopathy Fever Hodgkins lymphoma Non-hodgkins lymphoma

Right neck mass


Row of enlarged lymph nodes

Hodgkins Lymphoma:
Children & adults – double peak. Lymphadenopathy, painless, firm Fever, Eosinophilia Reed-Sternberg cells - B lymphocytes. ? Viral etiology



Hodgkins lymphoma

Non-Hodgkins Lymphoma:
Fever, anemia, infections Marked Lymphadenopathy No RS cells or eosinophilia Large group of different lymphomas
Clinical – low, intermediate & high grade.  Cell type – B cell, T cell, Histiocyte & other  Histology – Follicular & diffuse.

NHL- Histologic types

Diffuse - & - Follicular

NHL- Histologic types

Small – Intermed. – Large

Old age Malignancy of Plasma cells – B lymphocytes Lytic bone lesions. Marked antibody production – Monoclonal Hyper gammaglobulinemia – blindness Immunodeficiency – infections

Myeloma – Bone Marrow

Myelodysplastic syndromes:
Also known as refractory anemia Bone marrow dysplasia Formed Abnormal cells degenerate Pancytopenia After years transforms to leukemia

MDS - Dysplastic Erythroblasts

Myeloproliferative Disorders:
Excess proliferation of abnormal cells Marked organomegaly – spleen & liver. Problems are due to excess cells General Classification:
Polycythemia vera – (RBC)  Chronic Myeloid Leuk (WBC)  Essential thrombocythemia (PLT)  Myelofibrosis (Fibroblasts)

Blood Film
Plenty of Platelets Megakaryocyte

MPS : E.T. Bleeding

MPS - P. Rubra Vera (PV)

Leukemias – Starts in marrow spread to blood
Anemia, infections & Bleeding  Enlargement of Liver, Spleen lymphnodes  Acute/Chronic & Myeloid & Lymphoid.

Lymphomas – Tumors of lymphnodes.
Fever & lymphadenopathy  Types - Hodgkins & non- hodgkins

Premalignant conditions
Myelodysplastic syndromes -Refractory An  Myeloproliferative disorders -Excess proliferation

3 R’s of success:

Respect for self, Respect for others and Responsibility for all your actions.

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