Dr. Goswami Parth Rajendragiri
Pathology
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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Patient's Query
Hi doctor,
This query is regarding my 27-year-old girlfriend. She has had a rash-like patch on her breast. So, we were worried and went to a dermatologist, but the doctor said there was no problem and nothing to worry about. Afterward, we went for an ultrasound, but the results were normal. After that, we went to a breast surgeon as we were concerned it might be an inflammatory breast cancer, and he assured us that it was cellulitis and that we should stop worrying. However, I checked on some previous blood test reports, and we found that my girlfriend's immature granulocytes were always 0.03 to 0.04 mcl, but this time it was 0.10 mcl, which is slightly higher than the normal range. We are anxious, and we want to know what you think about the elevated 0.10 mcl results. In addition, I have a few questions, is the condition worrisome? What might have caused it? Can it be because of the infection or the inflammation? Should we worry about the 0.10 mcl result?
Kindly help us.
Hello,
Welcome to icliniq.com.
I went through your query and understood your concern. Here are my answers to your questions, in the attached report, the USG (ultrasonography) findings do not indicate any cancer (attachment removed to protect the patient's identity). In addition, her inflammation resolved clinically after three weeks, so it does not seem to be cancer. So, do not worry. Immature granulocytes can increase to some extent in case of infection, and the elevation is not that high in her case. So it does not signify any cancer as well.
I hope I have answered your question. Let me know if I can assist you further.
Patient's Query
Hi doctor,
Thank you for your reply.
All her blood test reports were normal except this one. So immature granulocytes can be elevated when there is an infection anywhere in the body? I read somewhere on the internet that if immature granulocytes are found in your bloodstream, it could mean a problem with your bone marrow. Or, it may indicate an early-stage response to infection, and healthy people do not show immature granulocytes on their blood reports. So what does it mean if immature granulocytes are found in the bloodstream? My dad, mother, sister, and I have around 0.03 - 0.06 mcl on our reports, and it has been the same every time we do a blood test. So, does it mean the elevated immature granulocytes in her blood are bad, or is there a problem with the bone marrow?
Kindly help.
Hello,
Welcome back to icliniq.com.
I can understand the reason for your anxiety. Immature granulocyte means the presence of myelocyte, metamyelocyte, and blast cells. These cells are precursor cells for the development of mature granulocyte. All blood cells form in the bone marrow, releasing them into the blood after maturation. In the case of blood cancer, like leukemia, these cells are increased to a greater extent, more than 30 percent, which is generally reflected in the blood report. So, if your immature granulocyte is elevated to this extent, we can think further, or else there is no need to worry. During an infection, the immature granulocytes are slightly increased due to stress on the bone marrow. So, do not worry.
I hope I have answered your question.
Patient's Query
Thank you doctor for the reply,
Is a jump from her normal 0.04 or 0.05 to 0.10 mcl something to worry about? This increase could be due to the fact that she had an infection in her breast, right?
Hello,
Welcome back to icliniq.com.
Yes, the mild elevation was due to her infection in breast tissue. In leukemia or blood cancer, immature granulocytes are usually very high, typically more than 30 percent, and with much higher counts. The percentage of immature granulocytes can be calculated in the peripheral smear examination report. So, do not worry. In the attached report (attachments removed to protect patient’s identity), it is only slightly elevated. Within a few weeks, it will likely return to within the normal range.
I jhope I have answered your question. Let me know if I can assist you further.
Regards.
Patient's Query
Thank you doctor for the reply,
I did not have any percentages mentioned in the report, but I am wondering how 30 percent or higher would look. Could you provide an example of how it appears in the context of the report?
Hello,
Welcome back to icliniq.com.
In the attached report, the other CBC parameters are also within the normal range. Your premature cells, which refer to immature granulocytes, have not increased significantly. They show only a borderline elevation, amounting to approximately 1-2 percent of all WBCs, as far as I can assume. Please do not worry.
Regards.
Patient's Query
Thank you doctor for the reply,
As you said, it might be 1 to 2 percent of all WBCs only, I assume. Does it mean 1 to 2 percent of immature granulocytes specifically because it says, "More than 2 percent immature granulocytes is a high count"? Does the value 0.10 refer to 1 to 2 or is it 1 to 2 percent for all the WBCs?
Hello,
Welcome back to icliniq.com.
Yes, more than 2 percent is considered high. However, in cases of cancer, it can increase to a much higher level, such as more than 30 percent. In your case, the immature granulocytes have increased only to a slight extent, and the value is not written in percentage as it was derived by the cell counter. You need not worry about this only being a borderline elevation. If you repeat the CBC after a few days, it is likely to be completely normal.
Regards.
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