Bain BJ. The peripheral blood smear. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 148. Show
Chernecky CC, Berger BJ. Differential leukocyte count (diff) - peripheral blood. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:440-446. Nasr MR, Hutchison RE. Leukocytic disorders. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 34. Lymphocytes are cells that work in our immune system and thus belong to the white blood cell family. Lymphocytes, neutrophils, monocytes, eosinophils, and basophils levels are assessed through a blood differential test (also called a white blood cell differential), as a part of a complete blood count. This test can detect abnormal or immature cells and can diagnose an infection, leukemia, or an immune disorder. A healthcare professional may order a blood differential when someone has general signs and symptoms of infection and/or inflammation, such as: - Fever, chills - Body aches, pains - Headache So called because they are the primary type of cell found in lymph, lymphocytes have three major types: T cells, B cells, and natural killer cells. Together, lymphocytes are the major component of our body’s adaptive immune response and usually account for approximately 20%-40% of the total white blood cells circulating at a given time. They act by identifying foreign objects, like bacteria and viruses, and generating a specific response that is tailored to maximally eliminate the invader. The blood differential test measures the percentage of each type of white blood cell (WBC) that you have in your blood. It also reveals if there are any abnormal or immature cells. How the Test is PerformedA blood sample is needed. A laboratory specialist takes a drop of blood from your sample and smears it onto a glass slide. The smear is stained with a special dye, which helps tell the difference between various types of white blood cells. Five types of white blood cells, also called leukocytes, normally appear in the blood:
A special machine or a health care provider counts the number of each type of cell. The test shows if the number of cells are in proper proportion with one another, and if there is more or less of one cell type. How to Prepare for the TestNo special preparation is necessary. How the Test will FeelWhen the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or slight bruising. This soon goes away. Why the Test is PerformedThis test is done to diagnose an infection, anemia, or leukemia. It may also be used to monitor one of these conditions or to see if treatment is working. Normal ResultsThe different types of white blood cells are given as a percentage:
What Abnormal Results MeanAny infection or acute stress increases your number of white blood cells. High white blood cell counts may be due to inflammation, an immune response, or blood diseases such as leukemia. It is important to realize that an abnormal increase in one type of white blood cell can cause a decrease in the percentage of other types of white blood cells. An increased percentage of neutrophils may be due to:
A decreased percentage of neutrophils may be due to:
An increased percentage of lymphocytes may be due to:
A decreased percentage of lymphocytes may be due to:
An increased percentage of monocytes may be due to:
An increased percentage of eosinophils may be due to:
An increased percentage of basophils may be due to:
A decreased percentage of basophils may be due to:
RisksThere is little risk involved with having your blood taken. Veins and arteries vary in size from one person to another, and from one side of the body to the other. Taking blood from some people may be more difficult than from others. Other risks associated with having blood drawn are slight, but may include:
Alternative NamesDifferential; Diff; White blood cell differential count Images
ReferencesBain BJ. The peripheral blood smear. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 148. Chernecky CC, Berger BJ. Differential leukocyte count (diff) - peripheral blood. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:440-446. Nasr MR, Hutchison RE. Leukocytic disorders. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 34. Review Date 1/19/2021Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. What is the normal percentage of lymphocytes in blood?Normal Results
The different types of white blood cells are given as a percentage: Neutrophils: 40% to 60% Lymphocytes: 20% to 40% Monocytes: 2% to 8%
What is high lymphocytes percentage?Lymphocytes normally represent 20% to 40% of circulating white blood cells. When the percentage of lymphocytes exceeds 40%, it is recognized as relative lymphocytosis.
Is 20 percent lymphocytes normal?In adults, about 20% to 40% of the white blood cells in your body are lymphocytes. These cells help protect your body from infection. If you have low numbers of lymphocytes (lymphopenia), you are at higher risk of infection.
Is 30% lymphocytes normal?Lymphocytes normally represent 20 - 40% of circulating white blood cells. The normal concentration of lymphocytes is between 1.0 - 4.0 x 109/L.
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