Ward P C
Postgrad Med. 1980 Feb;67(2):217-23. doi: 10.1080/00325481.1980.11715377.
The experienced morphologist can be extremely helpful to the clinician by virtue of his or her ability to distinguish among the various subtypes of reactive lymphocytoses. An awareness on the part of the clinician as to the nuances of subclassification may lead to earlier diagnosis of a disease process. Broadly, proliferations of normal lymphocytes point to infectious lymphocytosis or Bordetella pertussis infection. Proliferations of atypical lymphocytes, especially when minimum diagnostic criteria are present or there are four or more Downey III forms per 100 WBCs, suggest infectious mononucleosis. Proliferations of immunoblasts reflect hypersensitivity reactions to drugs or autoimmune disease. Proliferations of proplasmacytes or plasma cells favor viral hepatitis, drug reactions (notably to sulfa drugs), or rubella. Quantitative data may help refine the morphologic implications. Cumulatively, qualitative and quantitative data should lead the clinician to a judicious selection of confirmatory serologic tests and hence to earlier diagnosis.
经验丰富的形态学家凭借其区分各种反应性淋巴细胞增多症亚型的能力，对临床医生极为有帮助。临床医生若能了解亚分类的细微差别，可能会更早诊断疾病进程。一般来说，正常淋巴细胞的增殖指向传染性淋巴细胞增多症或百日咳博德特氏菌感染。非典型淋巴细胞的增殖，尤其是当存在最低诊断标准或每100个白细胞中有四个或更多的唐尼III型细胞时，提示传染性单核细胞增多症。免疫母细胞的增殖反映对药物的过敏反应或自身免疫性疾病。原浆细胞或浆细胞的增殖多见于病毒性肝炎、药物反应（尤其是对磺胺类药物）或风疹。定量数据可能有助于细化形态学意义。综合定性和定量数据应能引导临床医生明智地选择确证性血清学检测，从而实现更早诊断。
