Leukemoid Reaction: Unusual Causes

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Professor, Consultant Pathologist, American Board Certified Pathologist, Fellow College of American Pathologists. Areas of interest Fine Needle Aspiration Cytology, Cytology, Cancer, Ethics, Islam, Humanity

Leukemoid Reaction: Unusual Causes

Anwar ul Haque and Noor ul Aan

Increased neutrophils are considered to be indicative of acute bacterial infection. Not always true. Neutrophils are almost normal “flora”of PAP smears sometimes misinterpreted as “acute inflammatory”. We have yet to see a single PAP smear devoid of
neutrophils. We believe cervical mucin is strongly chemotactic for the neutrophils and hence they are always there; perhaps as preventive measure! Acute myocardial infarction contains numerous
neutorphils after initial insults. Certainly it is not acute
myocarditis. Fine Needle Aspiration Cytology (FNAC) of malignant tumors may yield numerous neutorphils signifying that tissue necrosis is an important causes of neutrophils invasion and their presence; not
necessarily related to infections.


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