Professional Documents
Culture Documents
Cell Type
Neutrophil
Neutrophilia
Neutropenia
Lymphocyte
25-35%
Lymphocytosis
Lymphopenia or Lymphocytopenia
Following a recent infection, Immune suppression drugs, HIV infection, acute stress Acute infections, stress, glucocorticoid s, aplastic anemia
Monocyte
2-10%
Monocytosis
Eosinophil
0-5%
Eosinophilia
Basophil
0-1%
Basophilia
Bacterial infection, malaria, sarcoidosis, ulcerative colitis, neoplasms Allergic reaction, helminth infection, fungal infections, Eczema, Eosinophilic leukemia Allergic reactions, Helminth infections,IDA, AML, CML, Myelodysplasia
Monocytopenia
Not applicable
Not applicable
MLAB 1415: Hematology Laboratory #9 Counting to 100 Each cell line should be examined for immature cells. Immature WBCs are not a normal finding in the peripheral blood. Presence of immature WBCs can indicate infections or malignancies such as leukemia. The neutrophilic line is the only cell line that immature cells are differentiated and identified in most laboratories. The term left shift refers to the presence of bands and younger neutrophilic cells. Specimen: Peripheral blood smear made from EDTA-anticoagulated blood. Smears should be made within 4 hours of blood collection from EDTA specimens stored at room temperature to avoid distortion of cell morphology. Unstained smears can be stored for indefinite periods in a dry environment, but stained smears gradually fade unless coverslipped. Reagents, supplies, and equipment: 1. 2. 3. 4. 5. Prepared slides Manual cell counter designed for differential counts Microscope Immersion oil Lens paper
100x oil objective. Find an area of the smear where the RBCs are overlapping
and are not overlapping. 6. Using a cell counter, begin the count in the thin area of the slide and utilize the battlement track to read the slide. Carefully push the button that corresponds to the cell you are counting until you reach 100 total WBCs.
MLAB 1415: Hematology Laboratory #9 Counting to 100 Procedural Notes: 1. If nucleated red blood cells (nRBCs) are observed, they are enumerated; however, they are NOT included in the 100 WBC total. If the cell counter has a nRBC button, the counter will not be include the nRBCs in the 100 WBCs total. If the cell counter does NOT have a nRBC button, you must keep a separate count of nRBCs you observe until you reach 100 WBCs. If you observe >5 nRBCs/100 WBC diff, the automated WBC count must be corrected by using a calculation you will learn in the Manual Differential Lab. 2. If atypical lymphocytes are observed, count them using the specified atypical/reactive lymphocyte button. If there is not a specified button, use a blank button on the cell counter. These are included in the total lymphocyte percentage, but need to be differentiated from normal lymphocytes. 3. If immature neutrophils (promyelocytes-bands) are observed, they must be identified and counted separately. These count toward the neutrophil percentage, but must be differentiated from mature neutrophils. In all other granulocytic or monocytic cell lines, immature cells (other than blasts) are included with the mature cell count. 4. Blasts of all cell lines will be classified as others in this lab. They will be counted by pressing a blank or other button. They will count toward the 100 WBC total and recorded in the Other % column on the report form. In most clinical laboratories, these would be referred to a pathologist for identification. Examples of Differential Cell Counters:
Report Form
Patient Name and ID or Slide Number Neutrophil % Lymphocyte % Monocyte % Eosinophil % Basophil % Others % # of nRBCs/100 WBC
Pro: Myelo: Meta: Band: Seg: Total: Pro: Myelo: Meta: Band: Seg: Total:
Atyp: Lymph
1. If you observed the following cell, what button would you press during your WBC differential?
2. According to ACC procedure, how would you classify the following cell at the arrow? (what column on report form)
3. If promonocytes are observed, how would you classify them? __________________________________________________________________________ 4. List four (4) causes of Neutrophilia. a. b. c. d. 5. List three (3) causes of Lymphocytopenia. a. b. c.