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Differential Leukocyte Count (DLC) 3

الكلية كلية طب الاسنان     القسم  العلوم الاساسية     المرحلة 2
أستاذ المادة وسن نجم عبد السادة الربيعي       21/02/2019 18:25:15
differential leukocyte count (dlc)

types of leukocytes:
there are two major types of white blood cells: granulocytes and agranulocytes as shown in the following table (1) and fig.1:

tab.1: characters of the types of wbcs
type of wbc diameter (?m) cytoplasm nucleus
i. granulocyte
neutrophil (n) 10-15 pink with fine violet- pink granules dark blue-purple, clumped nuclear chromatin, 2-5 lobes joined by a thin chromatin stand
eosinophil (e) 12-18 filled with large, round, uniform, orange-red granules, often no stained cytoplasm between granules usually bi-lobed, less dark staining and less intense nuclear chromatin clumping than neutrophils
basophil (b) 10-15 filled with densely-staining variable, purplish-black granules, often cover nucleus. u-shaped, fine nuclear chromatin pattern, often not visible
ii. agranulocyte
12-20 smoky blue, may have fine pink granules, may have vacuoles variable, large, u-shaped, may be folded or convoluted, fine chromatin strands
monocyte (m)
lymphocyte (l)
12-16 light blue, abundant occasionally can see pink granules round or slightly indented, no lobes darkly staining, clumped nuclear chromatin
large l.
small l. 10-12 very thin rim around nucleus, light blue, sometimes a perinuclear clear zone round, no lobes, deep purple, very clumped chromatin







































principle:
a blood film stained with leshman s stain is examined under immersion oil and the different types of white blood cells are identified. the percentage distribution of these cells is then determined.


procedure:
1. after the preparation and staining of blood film, place it on the stage of microscope.
2. examine the blood smear under 10x objective lense and choose an area where wbcs are numerous.
3. put two dropings of oil on the smear and examine by using oil immersion.
4. make differential count by moving the slide as shown in fig.(2).
5. count at least 100 wbcs (200 for good results). calculate the percentage of each type of the cell in the total count and compare with the normal values (tab.2)














table (2): differential leukocyte count (normal values)

type of wbcs percent
(%) absolute value
x 109 / l
neutrophils (n) 50-60 3.0-7.0
eosinophils (e) 1-4 0.05-0.25
basophils (b) 0-1 0.00-0.10
monocyte (m) 2-6 0.1-0.6
lymphocyte (l) 20-40 1.5-4.0



note:
decreasing or increasing of any type of wbcs refers to diagnostic disease or infection (tab.3).




tab.3: disorder values in dlc

type of wbcs increase decrease
n neutophila neutopenia
1. systemic acute infection (streptococci, staphylococci,…)
2. localized infection (tonsillitis, appendicitis, otitis)
1. metabolic disorder (uraemia)
2. tumors 1. infection ( malaria, typhoid, hepatitis,
influenza)
2. splenomegaly
3. acute leukemia
4. pernicious anaemia
e eosinophila eosinopenia
1. allergy
2. parasitic infection (malaria, toxoplasma, ascaris)
3. certain chronic skin diseases 1. increasing of acth
2. drugs (insulin, thyroxin, epinephrine)

b basophila basopenia
1. following radiation
2. chronic allergy
3. chronic hemolytic anaemia 1. hyperthyrodisim
2. drugs (steroids)
3. hereditary deficiency
m monocytosis monocytopenia
1. acute tuberclosis infection
2. mycosis unfection
3. typhoid, malaria
4. acute leukemia 1. rheumatoid arthritis
2. hiv infection
3. megaloblastic anaemia
l lymphocytosis lymphocytopenia
1. bacterial infection (typhoid, brucellosis, tuberclosis)
2. parasitic infection (toxoplasma, trichinellosis)
3. viral infection (hepatitis, rubella, herpes)
4. acute & chronic lymphoma 1. increasing of acth
2. immunoglobulins deficiency
3. chemotherapy & radiation
4. active tuberculosis infection
5. heart failure


المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .