Sandbox leucocytosis: Difference between revisions

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== Differential diagnosis of Lymphocytosis ==
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!Symptoms
!History
!Physical Examination
! colspan="3" |Laboratory Findings
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!CBC
!Blood smear
!Immunophenotype
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|'''Monoclonal B lymphocytosis'''
|Monoclonal population of B lymphocytes <5000 cells/microL
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* Without other features of
** Lymphadenopathy
** Organomegaly
** Cytopenias
** Extra-medullary involvement
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* Active or prior infections
* History of hematologic malignancy
* Medications
* Family history of chronic lymphocytic leukemia (CLL)
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* Fever
* Lymphadenopathy
* Hepatosplenomegaly
* Joint redness
* Abdominal pain
* Lung findings.
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* Lymphocytosis  ≥4000 lymphocytes/microL
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* Lymphocytes in MBL have no distinguishing appearance
* Appear as small, mature mononuclear cells.
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* CD19, CD20, and CD23
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* Does not require bone marrow examination or imaging for diagnosis
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|'''Congenital B cell lymphocytosis'''
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|'''Large granular lymphocyte leukemia'''
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|'''Chronic lymphocytic leukemia'''
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|'''Sezary syndrome'''
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|'''Mantle cell lymphoma'''
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|'''Follicular lymphoma'''
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|'''Splenic marginal zone lymphoma'''
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|'''Acute lymphoblastic leukemia'''
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|'''Acute Promyelocytic Leukemia'''
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|'''Diffuse Large Cell Lymphoma'''
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Revision as of 16:12, 15 August 2018

  • Leukocytosis is defined as an elevated white blood cell (WBC) count greater than 11,000 per mm3 (11.0 × 109 per L).
  • The most common type of leukocytosis is neutrophilia.
    • Neutrophilia can be defined as an increase in the absolute number of mature neutrophils to greater than 7,000 per mm3 [7.0 × 109 per L].
Differentiating Symptoms Differentiating physical exam findings Differentiating Labs
Physiological variation Birth
Adult
Pregnancy
Primary Congenital Heridatary neutrophilia
Chronic idiopathic neutrophilia
Down syndrome
LAD
Acquired CML
Polycythemia Vera
Secondary Infection Acute
Chronic
Connective tissue disorders RA
JRA
IBD
Chronic hepatitis
Drug induced Steriod
Lithium
Beta agonists
Cytokines
Marrow stimulation Hemolytic anemia
Immature thrombocytopenia
Post splenectomy
Metabolic Diabetic coma
Acidosis
Thyroid strom
Acute Gout
Seizures

Differential diagnosis of Lymphocytosis

Symptoms History Physical Examination Laboratory Findings
CBC Blood smear Immunophenotype
Monoclonal B lymphocytosis Monoclonal population of B lymphocytes <5000 cells/microL
  • Without other features of
    • Lymphadenopathy
    • Organomegaly
    • Cytopenias
    • Extra-medullary involvement
  • Active or prior infections
  • History of hematologic malignancy
  • Medications
  • Family history of chronic lymphocytic leukemia (CLL)
  • Fever
  • Lymphadenopathy
  • Hepatosplenomegaly
  • Joint redness
  • Abdominal pain
  • Lung findings.
  • Lymphocytosis ≥4000 lymphocytes/microL
  • Lymphocytes in MBL have no distinguishing appearance
  • Appear as small, mature mononuclear cells.
  • CD19, CD20, and CD23
  • Does not require bone marrow examination or imaging for diagnosis
Congenital B cell lymphocytosis
Large granular lymphocyte leukemia
Chronic lymphocytic leukemia
Sezary syndrome
Mantle cell lymphoma
Follicular lymphoma
Splenic marginal zone lymphoma
Acute lymphoblastic leukemia
Acute Promyelocytic Leukemia
Diffuse Large Cell Lymphoma