cells and tissues of the immune system

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Spleen

Differentiation of Blood CellsStem CellLineage specific markers cKIT +CD34+Common Lymphoid ProgenitorCommon myeloid progenitorLymphopoiesisMyelopoiesisSCF, IL-6, FLT3-LMyelopoiesisCommon Myeloid ProgenitorIL-3, GM-CSF, IL-6GM-CSFIL-5Thrombopoietin, IL-11CFU-GMCFU-eoCFU-b/Mg/ELineage specific markers cKIT +CD34+Neutrophil and Monocyte Maturation

CFU-GMCFU-GCFU-MBlastNeutrophilMonocyteG-CSFM-CSFNeutrophilMost common white blood cell and most common granulocyte (cells containing granules), 50-68% of white cells10-12 micronsPolymorphonuclear, up to four lobes attached by nuclear strandsLifespan, 3-4 days, once activated and digested bacteria their lifespan is 12 hoursFirst to respond to an infection Neutrophil FunctionsPhagocyticGranules contain; IV collagenase, phospholipase, complement activators myeloperoxidase (MPO), Cl- and H202 to HOCL. hypochlorous radicalDefensins, peptides that create holes in microbesLysozyme, degradation of bacteria wall MotilityDiapedesis, migrate through venules with recognition of endothelial receptors such as selectins and integrin receptors

Case 125-year-old homeless male presents to the ED with a chief complaint of chills and coughing when he smokes

Vital signs: T 101.5F, HR 82, BP 135/85 RR 17Labs: Left shift with bandemia

Left shift with Bandemia

Chest X-Ray And Pathologic Specimen, Diagnosis?

MonocyteLargest white cell, 18 micronsNucleus is indented or kidney bean shapedMonocytes differentiate into macrophages once they leave blood vesselsHistiocytes, in connective tissueOsteoclasts, in boneAlveolar cells, lungKupffer cells, liverMacrophages, lymph nodes, spleen and bone marrowLifespan, 3 daysMonocyte FunctionsMonocytes transform into macrophages and function as antigen-presenting cells in the immune systemDegraded antigens are presented on MHC II molecules to CD4+ T lymphocytesMacrophages phagocytose bacteria, other cells and debrisReactive oxygen species generated from the oxidative burstReactive nitrogen species, NO

Case 2A 55-year-old nun presents to the ED with a chief complaint of chest painHPI: She is 50 tall and 85lbs. She was watching a boxing match when she felt a crushing pain in her chest. The pain lasted about 15 minutes and ended shortly after she finished her cigarette and beer Lung Histology

Heart failure cells, siderophagesAntigen-Presenting cellsMacrophagesDendritic cells, initiation of T cell responseFollicular dendritic cells, display of antigen to B cellsCommon portals of entry for microbes contain antigen presenting cells (APCs), dendritic cellsSkinGastrointestinal tractRespiratory tract

Eosinophil Maturation

CFU-eoIL-5BlastEosinophilEosinophil1-5% of white blood cells, increased in numbers in patients with allergies, parasitic infections and chronic inflammation10-12 micronsBilobed nucleusEosinophilic granulesLifespan, 3-4 weeksEosinophil FunctionsDestruction of protozoans and helminthic parasitesGranules containMajor basic protein (MPO), arginine richEosinophil cationic protein (ECP)eosinophil peroxidase (EPO)Eosinophil-derived neurotoxin (EDN)Allergic reactionsGranules containHistaminaseArylsulfatase, neutralizes leukotrienes

Basophil, Erythrocyte and Platelet Maturation

CFU-b/Mg/ECFU-bCFU-MgBFU-EErythropoietinThrombopoietinBasophilErythrocytePlateletsBlastBasophilLeast numerous white cell,