Another example, phlegmon affecting the spine, is known as spondylodiscitis and is associated with endplate destruction and loss of disc height. In adults, the bone marrow is affected first, while in children, the disease starts in the disc itself and spreads rapidly to the adjacent vertebral bodies. Phlegmon in the spine can be a diffuse enhancement, or localized abscess, (peripheral enhancement) in the epidural, subligamentous or paraspinous spaces. Under MRI examination, phlegmon will show dark with T1, and high signal (bright) with T2.
If specimens are flagged for review, the following RBC morphological abnormalities, if present, are reported by the clinical laboratory scientist: polychromasia, acanthocytes (spur cells), ovalocytes (elliptocytes), spherocytes, sickle cells (drepanocytes), target cells (codocytes), schistocytes, stomatocytes, rouleaux and basophilic stippling. RBC inclusions (Howell Jolly bodies), granulocyte abnormalities (toxic granulation, Dohle bodies, Pelger Huet, hypersegmented polymorphonuclear leukocytes) and giant platelets are also reported if present.
Approach to lymphocytosis: ALC>4000/uL
It's either reactive or clonal:
- viral: HIV (in acute infection), EBV (mono), CMV, HHV6, HTLV-1
- bac: bordatella pertussis, bartonella (cat scratch disease)
- toxo, babesiosis (also causes hemolytic anemia)
2) Hypersensitivity reactions
- drugs, acute serum sickness
3) stress-induced (status epilepticus, trauma)
4) post splenectomy
5) polyclonal B cell lymphocytosis
3) LGL leukemia