Open AccessDiagnostic workup in front of an adult monocytosis
Author(s) -
J Labrousse,
Sophie Pasini,
G Vig,
Anthony Bonnin,
Philippe Mottaz,
François Carrère,
Pierre-Frédéric Augereau,
Philippe Aucher,
Franck Lellouche
Publication year - 2019
Publication title -
annales de biologie clinique
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.167
H-Index - 27
eISSN - 1950-6112
pISSN - 0003-3898
DOI - 10.1684/abc.2019.1475
Subject(s) - monocytosis , pathology , medicine , pathognomonic , context (archaeology) , differential diagnosis , eosinophilia , disease , biology , bone marrow , paleontology
The discovery of a monocytosis is a frequent phenomenon, requiring confirmation by reading under a microscope by an experimented biologist, to overcome usual cytological traps such as the presence of hairy cells, promonocytes or monoblasts. In the vast majority of cases the secondary origin is very easily found by the context and/or the presence of a biological inflammatory syndrome. More rarely the diagnosis is directed towards an eosinophilic pathology or an acute leukemia. In other cases, CMML, MPN or MDS with monocytosis may be highlighted. In the absence of any pathognomonic element and the presence of "borderline" forms the differential diagnosis between these 3 entities is not always straightforward, requiring, according to WHO, molecular investigations and elimination of any reactive cause of monocytosis. Although histological, immunohistochemical and phenotypic flow cytometric studies are not currently recommended by WHO, these investigations could be of interest in the evaluation of difficult cases.