Given a patient with an abnormal WBC your approach should be very staightforward. Basically you want to determine: 1. Which cell type or types are abnormal, and if the abnormality is reactive (due to an infection) or due to a neoplastic disorder such as leukemia. The Differential Leukocyte count is essential. 2. Then look to see if maturation is normal. Are immature cells present ? Are there any blasts? Is this an urgent problem? 3. Cell marker studies may be needed for lineage identification. 4. Clonality studies may be needed to identify neoplastic processes. Similar principles apply to patients with leucopenia.
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