ABNORMALITIES of the WHITE BLOOD CELLSJose R. Villarino, RMTossi!le ans"ers#A. NE$TROHILSB. L%MHOC%TESC. ATHOLO&ICD. H%SIOO&ICE. '()*( +,. -((().((((/0122&. ()3 +H. MALARIAI.A4$ROHILIC &RAN$LESJ. ASTHMA5. A$ER RODL. EL&ER H$ETM. TO6IC &RAN$LESN. LE$COENIAO. ARASITISM.SCARLET ,EVER7. DOHLE BODIESR. BAS5ET CELLSWBC Nor2al 8al1es#WBC Co1nt 9 -,((( : .(,(((/01 22or - : .( ; .(hil 9 -( : ?( + Se@2enter 9 -( : A- +BSta! 9 ( : - +Eosino>hil 9 ( : 3 +Baso>hil 9 ( : . +LC2>ho0Ctes 9 '( : *( +Mono0Ctes 9 ' : A +71antitati8e a!nor2alitiesLe10o0Ctosis : s1!stantial in0rease in the WBC 0o1nt. ) hCsiolo@i0 in0rease Dno tra12a/inE1rCF ) atholo@i0 in0rease Dtra12a/>atholo@CFLe10o>enia : s1!stantial Ge0rease in the WBC 0o1nt.N.V. 9 -,((( : .(,(((/01 22Di=erential Co1ntNe1tro>hil -( : ?- +se@2enter-( : A- +sta!( : - +Eosino>hil( : 3 +Baso>hil( : . +LC2>ho0Cte '( : *( + Mono0Cte' : A +The - WBC tC>es Ne1tro>hilia DH ? : I ;.(ost)s1r@erC, !1rns, HDNLithi12 Gr1@s, neo>las2sNe1tro>enia DK..?- : ..I.(roG10tion ) InheriteG/a0L1ireG ste2 0ell GisorGer ) BenMene to;i0itC, 0Ctoto;i0 Gr1@sIn0reaseG Gestr10tion ) I221ne 2e0hanis2, seL1estrationBM Ge>ression, IM, 8ari0ella, TC>hoiGSLE, he>atitis or anC 8iral infe0tionsEosino>hilia DH (.? ; .(enia DK (.(- ; .(hilD(.3 ; .(erthCroiGis2re@nan0C LC2>ho0Ctosis DH*.( ; .(s D>arotitisF, >ert1ssisT1!er01losis, sC>hilis, thCroto;i0osisLC2>ho>eniaCon@esti8e heart fail1re, SLERenal fail1reAG8an0eG T1!er01losisHi@h le8els of aGrenal 0orti0osteroiGsMono0Ctosis DH(.< ; .(hilis, T1!er01losisrotoMoan infe0tionsMC0oti0 or f1n@al infe0tionsMalaria, SCste2i0 l1>1s erCthe2atos1sRhe12atoiG arthritisMono0Cto>eniaLC2>ho0Cti0 le1Ne2iaA>lasti0 ane2ia7$ALITATIVE CHAN&ES)WBCMor>holo@i0 a!nor2alities in8ol8in@ either the n10le1s or 0Cto>las2,1n0tional a!nor2alitiesInheriteG or A0L1ireGE;a2ination of >eri>heral !looG or a !one 2arro" e8al1ation The White !looG 0ells#N10le1s Getails# ) Monon10lear or olC2or>hon10lear&ran1les >resent# ) &ran1lo0Cti0 or A@ran1lo0Cti0,1n0tion# ) ha@o0Cti0 or I221no0Cti0A!nor2al @ran1lo0Cte 2or>holo@C Da0L1ireGFTo;i0 @ran1lation, 0Cto>las2i0 8a01oleDohle !oGies DA2ato !oGiesFAM1ro>hili0 @ran1lesHC>erse@2entationatholo@i0al Le10o0CtesA!nor2al @ran1lo0Cte 2or>holo@C DinheriteGFAlGer)ReillC ano2alC ) Gense aM1ro>hili0 @ran1les, 210o>olCsa00haroiGosesMaC)He@@lin ano2alC ) &iant >latelets, Dohle)!oGies liNe in0l1sions seen e8en in 2ono0Ctesel@er H1et ano2alC : fail1re of nor2al se@2entation of n10le1s, !i)lo!eG n10le1s or sta! for2s onlC, P>in0e)neM n10le1sQAlGer ReillC ano2alCMaC)He@@lin ano2alCel@er H1et ano2alCContin1ation#CheGiaN Stein!rin0N Hi@ashi sCnGro2e : lar@e lCsoso2es 0ontainin@ hCGrolases anG other enMC2es. There is ane2ia,thro2!o0Cto>enia, le10o>enia anG in0reaseG s1s0e>ti!ilitC to infe0tion. There is >artial al!inis2 R >hoto>ho!ia.Also seen in Ale1tian 2inN, 2i0e, 0at, 0attle R Niller "hale as 0a1seG !C a!nor2al WBCs. CheGiaN Hi@ashi sCnGro2eOther a!nor2alities#S21G@e or !asNet 0ells : sL1ash)Ge@enerateG n10le1s of WBCsJorGanOs ano2alC : fat)0ontainin@ 8a01oles in WBC 0Cto>las2, I0hthCosisT"innin@ Gefor2itCA1er roG : roG)liNe str10t1re seen in the 0Cto>las2 of 2Celo!lasts, Gia@nosti0 for A01te 2Celo!lasti0 le1Ne2ia DAMLFVariants of the LC2>ho0Cteslas2a0CtoiG lC2>ho0Cte or T1rNOs irritation 0ellDo"neC 0ell DatC>i0al lC2>ho0CteFTransfor2eG lC2>ho0Cte Dreti01lar or >Cronino>hili0 0ellFReiGer 0ell : P0lo8er)leaf liNe n10le1sQlas2a 0ellsRea0ti8e lC2>ho0CtesDo"neC 0ell Hall2arN 0ell seen in 0ases of Infe0tio1s 2onon10leosis DNissin@ GiseaseFAtC>i0al lC2>ho0Cte Dstress lC2>ho0CteFP!allerina sNirt 0ellQInfe0tio1s Monon10leosislas2a 0ellsO8oiG or S!rillarC sha>eGE00entri0 lo0ation of n10le1serin10lear haloP0art)"heel >attern or s>oNe of the "heel >attern of n10le1sQ !aso>hili0 0Cto>las2Co2>arati8e 2or>holo@C of >las2a 0ells, lC2>ho0Ctes anG NRBCInheriteG a!nor2alities in8ol8in@ Mono0Cte)2a0ro>ha@e @ro1>M$COOL%SACCHAROIDOSES ) H1nter sCnGro2e, H1rlerOs GiseaseLIIDOSES : li>iG a00121lation ) &a10herOs Gisease : a00121lation of @l10o0ere!rosiGe G1e to la0N of !eta)@l10osiGase enMC2e ) Nei2ann i0N Gisease : s>hin@o2Celin anG 0holesterol a00121lation G1e to la0N of the enMC2e s>hin@o2Celinase Mono0Cte)2a0ro>ha@e a!nor2alitCWBC f1n0tionsNe1tro>hil : >ha@o0Cti0Eosino>hil : >ha@o0Cti0 anG Ga2a@e to lar8al sta@es of >arasite.Baso>hil : stora@e of hista2ine, in8ol8eG in i22eGiate hC>ersensiti8itC rea0tion.Mono0Cte : >ha@o0Cti0, 0ell1lar anG h12oral i221nitC,1n0tionsT.LC2>ho0Ctes : i221ne le10o0CtesaFh12oral !F lC2>hoNines 0F 0Ctoto;i0 ) Not o!li@ate enG 0ells ) Hetero@eno1s @ro1> of 0ells ) DestineG to 2i@rateHA&OC%TOSIS >ro0essMotilitC : ranGo2 2o8e2ent anG Gire0teG 2o8e2entRe0o@nitionIn@estionDe@ran1lation or release of @ran1lesMi0ro!ial Nillin@InheriteG f1n0tional a!nor2alitiesJo!Os sCnGro2e : Gefe0ti8e Gire0teG 2o8e2ent, 0hara0teristi0 P0olG !oilsQLaMC le10o0Cte sCnGro2e : !oth ranGo2 R Gire0teG 2o8e2ents are Gefe0ti8eCheGiaN Hi@ashi sCnGro2e : fail1re to release the @ran1lesNon)neo>lasti0 Dnon)0lonalF GisorGers of the WBCIn0l1Ge aF @ro"th re@1lation a!nor2alities, !F le1Ne2oiG rea0tion Dan in0reaseG >roliferati8e res>onse to 8ario1s sti21liF in0l1Gin@ !one 2arro" a>lasia anG hC>o>lasia anG 0F L1alitati8e le10o0Cte GisorGers D!oth a0L1ireG R inheriteGF 0hara0teriMeG !C GeS0ien0C of le10o0Cte f1n0tion.Non)0lonal GisorGers of WBC,1n0tion GisorGersDefe0ti8e 0he2ota;is, >ha@o0Ctosis, Gefe0ti8e Nillin@, C&D, 2Celo>ero;iGase GeS0ien0C71antitati8e GisorGers Ne1tro>enia, a@ran1lo0Ctosis, Le1Ne2oiG rea0tion, Infe0tio1s 2onoClonal Dneo>lasti0F GisorGers of WBCDeri8eG fro2 a sin@le >re01rsor 0ell "ith all the a=e0teG 0ells D>ro@enCF sho"in@ feat1res of Ge8iation fro2 the >re01rsor 0ell.MCelo>roliferati8e GisorGersLC2>ho>roliferati8e GisorGersI221no>roliferati8e GisorGersLe1Ne2oiG rea0tionHi@h WBC 0o1nt 9 K-((((/01 22To;i0 @ran1lation R Dohle !oGiesreGo2inant !anG for2sLA s0ore 9 H.((Ne@ati8e for hilaGel>hia 0hro2oso2e ) Translo0ation of @eneti0 2aterial fro2 lon@ ar2 of Chro2oso2e '' to Ch of 2ali@nant GisorGers referreG as LC2>ho2asLC2>ho2as in8ol8eG a!nor2al lC2>h noGe enlar@e2ent "ith re>la0e2ent or alteration in its histolo@i0 0hara0teristi0The neo>lasti0 0ell in8ol8eG is Nno"n as the ReeG)Stern!er@ 0ell. MostlC a>>ears as !in10leateG "ith the ' hal8es of the 0ell a>>earin@ as 2irror i2a@es. He2ato>oieti0 2ali@nan0CDeSneG as @ro"th or >roliferation of one or 2ore 0lones of a!nor2al 0ells. These 0ells GonOt res>onG to nor2al 0ontrol anG e8en >roG10e s1!stan0es inhi!itin@ @ro"th of nor2al 0ells. These 2ali@nan0C 2aC !e 2anifesteG in the >eri>heral !looG as in 0ases of ane2ia anG thro2!o0Cto>enia.Le1Ne2iasIn the 0ase of WBC, these 2ali@nant 0ells 2aC or 2aC not 0ir01late in the >eri>heral !looG. Hen0e, WBC 0o1nt 2aC !e in0reaseG or other"ise.Sho1lG these a!nor2al 0ells !e >resent !oth in the !one 2arro" anG the >eri>heral !looG, the ter2 le1Ne2ia is 1seG.Ale1Ne2i0 le1Ne2ia : if onlC 0onSneG to the 2arro" anG Go not 0ir01late.ClassiS0ation of the le1Ne2iasA00orGin@ to the ste2 0ell line in8ol8eG ) MCeloiG : in8ol8es the @ran1lo0Ctes, 2ono0Ctes, RBCs anG 2e@aNarCo0Ctes. Also Nno"n as 2Celo>roliferati8e GisorGers or nonlC2>ho0Cti0 le1Ne2ias. ) LC2>hoiG : in8ol8in@ the B or T 0ells anG 2aC !e a le1Ne2ia or lC2>ho2aClassiS0ation of le1Ne2iasA00orGin@ to G1ration Dlife s>anF) A01te : GaCs to "eeNs D3 2onthsF ) @reater than 3( + !lasts for2s) Chroni0 : 2ore than a Cear D.)' CearsF ) less than .( + !last for2sE;a2>les #A01te 2CeloiG le1Ne2ia 2Celo!lastChroni0 2Celo@eno1sle1Ne2iaMCelo0Cte, 2eta2Celo0Cte R ne1troA01te lC2>ho!lasti0le1Ne2ialC2>ho!lastsChroni0 lC2>ho0Cti0le1Ne2iaS2all 2at1re lC2>hErCthrole1Ne2iaDi &1@liel2o sCnGro2eH -(+ of the n10leateG 0ells are erCthro!lastsCo22ents on the le1Ne2ias#AML : 2ost 0o22on for2 of a01te le1Ne2ias in Srst fe" 2onths of life, in 2iGGle a@eG @ro1> anG later CearsCML : 2ore 0o22on in Co1n@ R elGersALL : seen a2on@ 0hilGren ' : .( C.o.CLL : 0o22on a2on@ H A( Cears olG