Chapter Summary

Leukocytosis is a common reactive pattern of white cells; determining whether the leukocytosis is related to neutrophilia, eosinophils, monocytosis, or lymphocytosis may be helpful in narrowing the diagnostic possibilities.

Infectious mononucleosis is a common viral disease typically lasting 4 to 6 weeks that can cause lymphocytosis, fever, sore throat, lymphadenitis, and hepatosplenomegaly.

Acute nonspecific lymphadenitis tends to cause tender lymph nodes and can be seen with bacterial or viral infections. Chronic nonspecific lymphadenitis tends to cause non-tender lymph nodes and can be seen with chronic inflammatory conditions, viral infections, medicines, and in nodes draining cancers.

Acute leukemias are characterized by more than 30% blasts in the bone marrow, which may also be identified in the peripheral blood. Clinically, acute leukemias cause symptoms related to marrow ; failure, such as anemia, fatigue, increased infections, fever, and bleeding. >

Non-Hodgkin lymphomas are classified by a variety of schemes, including the REAL (most current) classification, the Working Formulation, and the Rappaport classification.

Acute lymphoblastic leukemia (ALL) is a leukemia of precursor lymphoid cells that may be of either B-cell or T-cell lineage. The early pre B-ALL is usually seen in children and is the most common type of ALL. T-ALL typically causes a mediastinal mass in adolescent or young adult men. A similar presentation to T-ALL is seen in lymphoblastic lymphoma, which is usually of T-cell lineage.

Chronic lymphocytic leukemia and small lymphocytic lymphoma are very similar diseases that differ in whether they present with blood findings or lymph node findings. Both conditions are proliferations of small B cells that characteristically have B-cell markers with one T-cell marker (CD5). These are '

indolent diseases of the elderly. •

Hairy cell leukemia is an indolent disease of older men with characteristic lymphocytes with "hair-like" ; cytoplasmic projections that stain positive for TRAP.

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