Atyp. Lym stands for atypical lymphocyte. When first described in the mid 1920s, it was thought that they were a diseased cell that was causing the patient's distress. Hence the name for the term 'atypical' in pathology means abnormal. In the mid 1960s, when Robert Good figured out the immune system, he discovered that these cells were not diseased at all but that they were part of your immune system's defense against a foreign antigen. So most folks changed the name to 'reactive' or 'stimulated' or committed' (reactive finally won) in order to be more correct in the naming.

So - for the most part, 1 or 2 reactive lymphocytes in a differential is considered to be a normal response to some antigen and in the winter with the increase in cold viruses or during seasonal allergy season they are quite common. Fourteen percent is high and should be investigated. Sometimes that investigation is simply to say "oh yes I have a cold". Other times it needs additional testing.

Differentials are reported in two formats. The first and most traditional is the percentage. The second is called the absolute count which is calculated by multiplying the total WBC by the percent of the cell in question so out of the 18.2 WBC you have 2.5 of them are reactive lymphocytes.

Jack, increased numbers of monocytes are found in tons of situations. They range from benign - primary diseases (example - infectious monocytosis) to hematologic diseases (hemolytic anemia) to inflammatory and immune disorders (rheumatoid arthritis) to infections(tuberculosis) to gastro - intestinal disorders (ulcerative colitis) and the list goes on before it gets to malignant disorders.

Increased numbers of Eosinophils occur in drug reactions, allergies and parasite infections. while increased numbers of basophils occur in allergies. Both are increased in malignant disorders such as leukemia. If all of these are absolutely elevated and not just in percentage, then it usually means that the bone marrow is working overtime for some reason and may need to be checked on with additional testing.

When looking at lymphocytes, they can be divided into various types of categories. One way is to divided them into B, T or NK cells. Another way is to categorize them by age. Using that method, they are either lymphoblasts (very immature looking with no significant function), prolymphocytes (immature looking but not as young as the blasts and having some function) and finally lymphocytes (mature and functional to a degree). Prolymphocytes are not the world's best sign as their presence usually means that there is an increased stress of the cells preventing them from maturing.

Sometimes these cells show up transiently when there is a viral infection or some reaction to a medication or other stress and then they go away after the stress has been dealt with. Other times, they stay and usually treatment comes "sooner".

Diana - first some background information - The typical white cell population consists of cells that contain lots of granules (granulocytes) and have nuclei which are shaped something like sausage links - usually 2 to 4 lobes. they are also further subdivided into 3 different cell types based on the type of granules present (neutrophils, eosinophils and basophils). Lymphocytes and monocytes. were originally designated as not containing granules and were grouped as "mononuclear" cells as their nuclei were usually round or oval or at least not containing overt lobes. As time and better microscopy has occurred, both lymphcytes and monocytes were shown to have granules and monocytes in particular can have rather unusual shapes to their nuclei but the name "mononuclear" has stuck.

The term "atypical" is a term from pathology and usually means "malignant" or "abnormal" as in 3+ atypia when observing a biopsy specimen. The first time that this term was used in a specific hematology situation was almost 100 years ago when the presence of unusual looking cells was noted in the blood of a group of persons with the same symptoms. It was believed by the observer that the cells were causing the disease and thus the cells themselves were abnormal. We know today that the disease is Infectious Mononucleosis and these cells are lymphocytes which are reacting to the presence of the virus and are your major defense against the disease not its cause. But that adjective stuck too. While most laboratories use the current correct nomenclature, many still rely on "what they learned".

So - what is an atypical mononuclear cell? More often than not, it is not a granulocyte but either a lymphocyte or monocyte which has an unusual appearance. When someone is looking at a cell which the observer or instrument can not identify through the usual means, there are two route to follow. One is to ask someone or a group of someones to help identify the cell and the other is to report out "atypical mononuclear cells", leaving it up tot he physician to decide if these cells are worth further investigation. Yes, it is possible that these cells are more than unusual and actually clinical significant for some condition but I would have assumed that her pediatrician would have been up on that.

As to her microcytic anemia, there are several explanations/possibilities which need investigation. The most common anemia in children is iron deficiency which causes microcytes. Iron deficiency can occur due to poor eating habits (dislike of meat, overcooking vegetables, "grazing" style of eating, etc.) or interference with iron absorption (that might have some connection with any medications she might be on) or bleeding. Other possibilities include but are not limited to exposure to heavy metals such as lead or an inherited condition called thalassemia. in any event, each of these can be identified and treated appropriately.

Ummm, basophils are cells which are active in allergic reactions, specifically systemic rather than localized reactions. So they are increased in situation where you have bee stings, rather than poison ivy for example.

Monocytes are the general scavenger cells. They are the first line of defense against foreign antigens and damaged tissue. People with trauma such as heart attacks or broken bones,etc have increases in monocytes.