The haematological emergency - Extreme leukocytosis - Calendar 2008 month 4

Author(s): H. Diem (1), R. Hinzmann, F. Forstreuter (2)
Institution(s): (1) Würmtal-Labor, 82131 Gauting; (2) Sysmex Europe GmbH, Norderstedt - Germany
References: The Sysmex Scientific Calendar 2008;
Photos and text: Heinz Diem, MD; text: Rolf Hinzmann, MD, PhD; Frauke Forstreuter, PhD
Last change of this image collection: 2008/01/01

Leukocytosis is defined by a leukocyte count above the reference interval (ca. 4,000-10,000/µL in adults). At concentrations above 100,000/µL there is a high risk of hyperviscosity syndrome, depending on the prevailing cell population or the underlying disease (for example CLL, AML, CML).

The differential blood count shows a strikingly elevated lymphocyte count. In detail: Leukocytes: 188,300/µL, Granulocytes: 8,500/µL, Lymphocytes: 176,700/µL. After further examination chronic lymphocytic leukaemia (B-CLL) was diagnosed

Leukocytosis can often already be identified by a thick leukocyte layer ('buffy coat'). Here, in a patient with leukocytosis (leukocyte count 190,000/µL with CLL) it measures about 4 mm (->), whereas in a normal person (right) it is just recognisable as a thin layer above the erythrocytes.

Transitional form of chronic lymphocytic leukaemia / prolymphocytic leukaemia with a leukocyte count of 250,000/µL. Prolymphocytes are indicated (->).

Leukocyte count of 170,000/µL in acute myeloid leukaemia (AML-M4).


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