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WBC DifferentialBy Jillian Giguere
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How Is It Used?
assesses the ability of the body to respond toand eliminate infection
detects the severity of allergic and drug
reactions detects response to parasitic and other types of
infection.
used in evaluating the reaction to viral infections
and response to chemotherapy used to identify various stages of leukemia
assess platelet numbers and RBC morphology
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When is it ordered?
Run as part of the CBC
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Differential Count
Examination of the leukocytes and
classification of cells into different types
Used to diagnose and monitor thetreatment of leukemias, anemias, and
other diseases
Record how many of each of the five types
ofWBCs seen
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Normally we count 100WBC's, the normalor reference ranges are approx.
Neutrophils----------- 60%
Lymphocytes--------25%
Monocytes------------11%
Eosophils--------------3%
Basophils--------------1 %
NNeverLet Monkeys Eat Bananas
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APPEARANCE circular
light-grey to pink cytoplasm
diameter: ~14m
granules are very fine and range incolorfrom reddish-violet to brown
nucleus is bent and oblong partly with
constrictions which have not yet resulted in
filament
NORMALRANGE Between 1.6 and 7.4 x 109/L
FUNCTION
defense against bacterial infections by
phagocytizing the pathogens and killing them
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Clinical Significance
neutrophilia
neutropenia under 0.5 x 109/L, severe neutropenia
is present. This condition can be life
threatening since it can lead to severeinfections.
The neutrophil count usually is between 1.6 and 7.4 x 109/L
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APPEARANCE
round slightly larger than neutrophil
granulocytes
diameter: 16 m
granules are coarse, bright red to honey-
yellow and very densely packed
nucleus is usually bilobed
NORMALRANGERarely found in blood film
Between 0.02 and 0.4 x 109/L
FUNCTION
role is not completely clear
play an important role in allergic diseases, as
well as in parasitic infections
capable of phagocytosis and migration
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eosinophilia
eosinopenia
Clinical SignificanceThe eosinophil count usually is between 0.02 and 0.4 x 109/L
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APPEARANCE
diameter: 10 to 14m smaller than theother granulocytes
granules are coarse, dark violet, tightly
packed and extensively overlay the nucleus
and cytoplasm
NORMALRANGERarely found in blood film
Between 0 to 0.15 x 109/L
FUNCTION
P
lay an important role in hypersensitivityreaction
Able to leave the bloodstream and to
emigrate to the surrounding tissue
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basophilia
Clinical SignificanceThe basophil count usually is between 0 and 0.15 x 109/L
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monocytosis
monocytopenia
Clinical SignificanceThe monocytes count usually is between 0.2 and 1.0 x 109/L
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APPEARANCE
round to oval nucleus approximately the size of erythrocytes
cytoplasm is grey-blue
cell size varies between 9 and 20m
large and small lymphocytes aredistinguished by the volume ofcytoplasm
difference in size is an expression of
different states of activation
NORMALRANGEBetween 1.0 and 3.5 x 109/L
Second most frequent leukocyte in the
blood film after neutrophilic granulocytes
FUNCTION participate in cellular and humoral
defense against infection
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have large volume ofcytoplasm with clear azure granules
constitute 5-10% of all lymphocytes
correspond to either a subpopulation of T-cells or natural killercells
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lymphocytosis
lymphopenia
Clinical SignificanceThe lymphocytes count usually is between 1.0 and 3.5 x 109/L
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APPEARANCE
rarely found in peripheral blood diameter: 15 to 20m, they are larger than
lymphocytes
features include an eccentric nuclei and
perinuclear halo
NORMALRANGEBetween 0 and 0.1 x 109/L
Rarely found in the blood film
FUNCTION
produce antibodies for defense against
infection
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http://www.getbodysmart.com/ap2/circulatorysystem/blood/wbcs/wbcdifferential/tutorial.html
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1. Prepare blood smear on slide.
2. Dip slide in stain for 10 seconds.
3. Dip slide in distilled water (pH 6-7) for 20 seconds (or more for darker staining).4. Air dry.
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1 2 3 4 5 6
7 8 9
10 11
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12 13 14 15 16 17
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1. segmented (mature) neutrophil
2. band (immature) neutrophil
3. eosinophil
4. basophil
5. lymphocyte
6. monocyte
7. neutrophil
8. eosinophil
9. basophil
10. small lymphocyte
11. large lymphocytes
12. neutrophil
13. monocyte
14. eosinophil
15. monocyte
16. eosinophil
17. basophil
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