What is the reason of heterotypic lymphocyte?

summary

There are several kinds of blood cells in human blood. Red blood cells and granulocytes are called terminal cells, which means that there is no turning back in their life and they must go on until they die. In addition to performing their own functions, such cells do not change in any form. However, lymphocytes are not terminal cells, and they can also undergo some changes, such as protocellization and immature cellization (commonly known as "Atavism").

What is the reason of heterotypic lymphocyte?

Such changes are usually caused by the stress response of virus or drugs. Under the microscope, we can see that the cell volume becomes larger, the nuclear volume also increases, the color of cytoplasm deepens, and vacuoles appear. This is obviously different from the normal lymphocyte morphology. At this time, heterotypic lymphocytes should be reported. The normal value of human atypical lymphocytes is 0-2.0%.

Type I, also known as vacuolar or plasma cell type. The cell body was slightly larger than that of normal lymphocytes, and most of them were round, oval and irregular. The nucleus is round, kidney shaped, lobulated and often partial. The chromatin was rough, reticular or small, and arranged irregularly. Abundant cytoplasm, dark blue, vacuoles or foamy.

Type II, also known as irregular type, or monocyte type. The cell body is large and irregular in shape, with multiple pseudopodia. The shape and structure of the nucleus are the same as type I, or more irregular, and the chromatin is rough and dense. The cytoplasm is rich, stained light blue or gray blue, with a sense of transparency, dark staining at the edge, generally without vacuoles, and a few azure granules.

matters needing attention

The increase of heterotypic lymphocytes is not necessarily lymphocytic leukemia. For example, there is a disease called infectious mononucleosis, which can lead to the increase of heterotypic lymphocytes in the blood, even up to 20% - 30%（ The reference value was < 10%. This kind of disease is EB virus infection, most of which are infected by saliva. The existence of infection can be confirmed by checking the antibody of EB virus in blood. Other virus infections sometimes have the same reaction, and some drugs can also trigger the stress reaction of lymphocytes, so it is not necessary to be reckless when several heterotypic lymphocytes appear. However, if the number of heterotypic lymphocytes continues to increase, we should not be careless, but also do some other tests, such as lymphocyte immunotyping, cytochemical staining, etc., to exclude lymphocytic leukemia.