Does a rise in lymphocyte indicate leukemia or lymphoma?

Question

Hello doctor,

I had a viral infection for two months, with a fever for five days, a cough, and increased mucus production for more than two weeks. On a follow-up visit with a PCP, I was given antibiotics for five days, Azithromycin and an antihistamine, Levocetirizine, to make sure there is no secondary infection and to help with mucus (allergies were also suspected).

I feel great for a few weeks now, and currently, I am not taking anything. I have attached my blood work done yesterday, including CBC and peripheral blood smear. As you can see, although my overall WBC count is normal, there is a relative lymphocytosis (42 percent, up from 40 percent two weeks ago). The blood smear is normal. My hs-CRP is 0.9, and ESR (denoted as VHS) is at 2 mm/hr (millimeter per hour).

What can cause this relative elevation in lymphocytes?
Should I be concerned about leukemia or lymphoma?

Kindly guide.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have seen your attached report (attachment removed to protect patient identity).

The lymphocytes are slightly elevated. The lymphocytosis seems most likely to be due to a previous viral infection of the upper respiratory tract.

The peripheral blood smear report does not show any abnormality. So you need not worry about any leukemia or lymphoma, according to the provided history and reports. Do not worry.

You can repeat your CBC (complete blood count) after a week. The count of lymphocytes will fall within range after a week, mostly.

I hope this helps.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

The lymphocytosis can persist for a few weeks in some patients. It can remain elevated up to six to eight weeks sometimes.

In case of lymphocytosis, the patient usually fears CLL (chronic lymphocytic leukemia) or lymphoma. In CLL, the lymphocytosis is much higher, but in your case, it is borderline.

Additionally, in CLL, the peripheral smear shows smudge cells, which are not seen in your case. So, I am excluding leukemia or lymphoma, especially CLL.

The myeloid cells are also not seen in the mentioned differential count, so I can exclude other leukemias as well. Finally, based on the provided history and attached report, you may not need to worry about leukemia.

I hope this helps.

Thank you.