HomeAnswersHematologyhigh lymphocyte countI have had a high lymphocyte count for a year. Do I have leukemia?

Can a high lymphocyte indicate leukemia or lymphoma?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At September 24, 2022
Reviewed AtAugust 9, 2023

Patient's Query

Hello doctor,

I have had a high lymphocyte count for a year now. Last year, my lymphocyte count was 5.2 per µL of blood, and one month later, it was 5.0 per µL of blood. My WBC is on the higher end at 10,000/µL. A smear test came to the conclusion of reactive lymphocytes. This year, my lymphocyte count was at 3.8 per µL of blood, lower than last year, and my WBC is at 10,000/µL again. I visited the hematologist, and my lymphocytes were at 4.2 per µL of blood. I had a flow cytometry and had rare atypical reactive lymphocytes with no diagnostic features of a lymphoproliferative disorder. The hematologist says that I am fine, but I am worried. I have had a palpable lymph node for a couple of months and had a CT scan that came back with normal morphology and a fatty hilum and measured 10 mm x 6 mm. What else can I do? I am very worried that I have leukemia or some type of lymphoma or cancer. I need help. Kindly advise.

Thank you.

Hello,

Welcome to icliniq.com.

Following is my opinion on your asked question. You have absolute lymphocytosis history. When it persists for more than 6 months, especially above 4.5 µL of blood, then flow cytometry is indicated. Flow cytometry is so planned in your case, and the attached flow cytometry report does not suggest any chronic lymphocytic leukemia or lymphoma. There are no pre-mature cells or blasts as well. So you need not worry about other blood cancer as well. If you have enlarged lymph nodes, then FNAC (fine needle aspiration cytology) or biopsy for histopathology can be done for further workup of the enlarged node.

Do not worry. I hope I have answered your question. Let me know if I can assist you further.

Best regards.

Patient's Query

Hello doctor,

Thank you for your answers. What else could be causing the higher than normal lymphocyte count? What tests should I be asking for, and how do I get my lymphocytes to return to normal?

Hello,

Welcome back to icliniq.com.

Following is my further opinion on your asked question. The common cause of lymphocytosis includes chronic viral infection, especially hepatitis, infectious mononucleosis, HIV, etc. Autoimmune disease is also one of the causes of it. However, an investigation should be suggested according to the physical examination by a doctor. You might have some reactive lymphocytosis, and for that, an investigation needs to be done according to examination. SGPT (Serum Glutamic Pyruvic Transaminase), ultrasound abdomen, HIV testing, serum ANA (antinuclear antibody) testing, etc., are some of the investigations that can be done for further work up. Lymph node biopsy or FNAC (fine needle aspiration cytology) also should be done.

Kindly discuss all these with your treating hematologist or physician.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Goswami Parth Rajendragiri
Dr. Goswami Parth Rajendragiri

Pathology

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