Hematology and Oncology Book

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Neutrophil CountAka: Neutrophil, PMN Count, Neutrophilia, Stress Leukocytosis, Band Neutrophil, Left Shift, Demargination, Absolute Neutrophil Count, Neutrophilic Leukocyte, Polymorphonuclear Leukocyte, PMN, PML

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  1. Definitions: Left Shift
    1. Increased number of immature neutrophils (band forms)
    2. Suggests acute inflammation
  2. Characteristics
    1. Function: Primary defense against bacterial infection
      1. Phagocytizes and digests microorganisms
      2. Responds to several sources of chemotaxins
        1. Macrophage released Interleukin
        2. Basophil and Mast Cell released Histamine
        3. C-Reactive Protein Induced Complement Activation
    2. Morphology on Blood Smear
      1. Granulocyte with neutral staining on Wright Stain
      2. Nucleus with 3 to 5 lobes connected by thin chromatin
      3. Cytoplasm with fine granules
  3. Normal Count
    1. Range: 50-70% of White Blood Cells
    2. Bands: 2-6% of White Blood Cells
    3. Absolute Neutrophil Count (ANC) >1500 Neutrophils/mm3
  4. Decreased Neutrophils
    1. See Neutropenia
  5. Increased (Neutrophilia): ANC > 7500/mm3
    1. Physiologic Increase (Demargination)
      1. Release of cells in marginal pool
      2. Mediated by stress (Stress Leukocytosis)
        1. Exercise
        2. Seizures
        3. Anxiety
        4. Epinephrine
    2. Acute bacterial infection (and other infections)
    3. Tissue Injury and Inflammation
      1. Myocardial Infarction
      2. Burn injury
      3. Collagen vascular disease
      4. Hypersensitivity Reaction
    4. Metabolic condition
      1. Acute Renal Failure
      2. Eclampsia
      3. Ketoacidosis
    5. Myeloproliferative disorder
      1. Myelocytic Leukemia
      2. Myeloid metaplasia
      3. Polycythemia Vera
    6. Miscellaneous causes
      1. Hemolytic Anemia
      2. Acute hemorrhage
      3. Splenectomy (Leukocytosis may persist months)
    7. Neoplasms
      1. Metastatic cancer
    8. Medications
      1. Corticosteroids
      2. Lithium
      3. Beta agonists
  6. References
    1. Wilson (1991) Harrison's Medicine, McGraw, p. 360-1

Leukoencephalopathy, Progressive Multifocal (C0023524)

Definition (MSH)An opportunistic viral infection of the central nervous system associated with conditions that impair cell-mediated immunity (e.g., ACQUIRED IMMUNODEFICIENCY SYNDROME and other IMMUNOLOGIC DEFICIENCY SYNDROMES; HEMATOLOGIC NEOPLASMS; IMMUNOSUPPRESSION; and COLLAGEN DISEASES). The causative organism is JC Polyomavirus (JC VIRUS) which primarily affects oligodendrocytes, resulting in multiple areas of demyelination. Clinical manifestations include DEMENTIA; ATAXIA; visual disturbances; and other focal neurologic deficits, generally progressing to a vegetative state within 6 months. (From Joynt, Clinical Neurology, 1996, Ch26, pp36-7)
Definition (CSP)demyelination in various part of the central nervous system, usually secondary to neoplastic disease; JC virus has been recovered from brain tissue.
ConceptsDisease or Syndrome (T047)
ICD9046.3
EnglishENCEPH JC POLYOMAVIRUS, JC POLYOMAVIRUS ENCEPH, JC Polyomavirus Encephalitis, JC Polyomavirus Encephalopathy, LEUKOENCEPH PROGRESSIVE MULTIFOCAL, Multifocal leucoencephalopathy, Multifocal leukoencephalopathy, PML, PROG MULTIFOC LEUKOENCEP, Progressive multifocal leucoencephalopathy, PROGRESSIVE MULTIFOCAL LEUKOENCEPH, Progressive Multifocal Leukoencephalopathies, Progressive Multifocal Leukoencephalopathy
Spanishleucoencefalopatía multifocal, leucoencefalopatía multifocal progresiva, leucoencefalopatia multifocal, leucoencefalopatia multifocal progresiva
CreditsDerived from the NIH UMLS (Unified Medical Language System)


neutrophil (C0027950)

Definition (MSH)Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes.
Definition (CSP)granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes.
Definition (NCI)(NOO-tro-fil) A type of white blood cell.
Definition (NCI)Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes.
ConceptsCell (T025)
Englishheterophil granulocyte, neutrophil, neutrophilic granulocyte, neutrophilic leukocyte, Neutrophils, Polymorph, Polymorphonuclear Cell, Polymorphonuclear cells, Polymorphonuclear leucocyte, Polymorphonuclear leukocyte, Polymorphonuclear Leukocytes, Polymorphonuclear Neutrophils, Polys
Spanishleucocito polimorfonuclear, neutrófilo, neutrofilo
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Neutrophilia (C0151683)

ConceptsFinding (T033)
EnglishNeutrophilia, Neutrophilic leucocytosis, Neutrophilic leukocytosis
Spanishleucocitosis con neutrofilia, leucocitosis neutrofílica, leucocitosis neutrofilica, neutrofilia
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Left shifted white blood cells (C0240173)

ConceptsFinding (T033)
EnglishIMMATURE LEUKOCYTES INCREASED, Left shift, Left shift leukocytic maturation alteration, Left shift of WBC, Left shifted white blood cells, Leukocytes.left shift
Spanishalteración de la maduración leucocítica con desviación hacia la izquierda, alteracion de la maduracion leucocitica con desviacion hacia la izquierda, desviación hacia la izquierda del recuento de glóbulos blancos, desviacion hacia la izquierda del recuento de globulos blancos, recuento de glóbulos blancos con desviación hacia la izquierda, recuento de globulos blancos con desviacion hacia la izquierda
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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