WHAT IS A LYMPHOCYTE?

A lymphocyte is a type of white blood cell present in the blood. A cell is the smallest, most
basic unit of life, that is capable of existing by itself. White blood cells help protect the body
against diseases and fight infections. When the general defense systems of the body have been
penetrated by dangerous invading microorganisms, lymphocytes help provide a specific response
to attack the invading organisms. A microorganism is a tiny organism made of one cell that is
usually too small to be seen without using a microscope. Lymphocytes help to protect the body
against tumors (tissues that grow more rapidly than normal). However, lymphocytes can also
cause the rejection of tissues during organ transplants because they interpret these tissues as
foreign invaders.

WHAT ARE SOME OTHER CHARACTERISTICS OF LYMPHOCYTES?

Lymphocytes are small white blood cells, usually 7 to 8 micrometers in length. A micrometer is
a very small unit of length that measures one millionth of a meter. A meter is approximately 39
inches (slightly more than 3 feet). Larger forms of lymphocytes are usually about 10 to 20
micrometers in length.

The nucleus (central structure) of a lymphocyte is made of large groupings of thin threads known
as chromatin. The nucleus of a lymphocyte stains dark purple/blue when exposed to a stain
known as Wright's stain. You can see what this looks like right here. As you can see, the nucleus
is usually round but can be slightly indented. Also, the nucleus is surrounded by a small amount
of light blue cytoplasm (a gooey substance that fills up a cell).

Unlike other types of white blood cells, such as basophils and eosinophils, the cytoplasm of
lymphocytes usually do not contain large, rough-looking, grain-like particles. However, larger
forms of lymphocytes may have a lot of cytoplasm that contain several bright reddish/purplish,
rough-looking, grain-like particles. Unlike some other types of cells, the granules of lymphocytes
do not turn a blue color when exposed to certain types of chemical used in laboratory tests.

WHAT DOES A LYMPHOCYTE LOOK LIKE?

A lymphocyte looks like this under a microscope:

WHERE ARE LYMPHOCYTES MADE?

Lymphocytes are formed in lymphatic tissue throughout the body. Lymphatic tissue are a
network of fibers and cells that help protect the body against disease. Examples of places in the
body where lymphocytes are made that are made of lymphatic tissue include the spleen, thymus,
tonsils, and lymph nodes. The spleen is an organ next to the stomach that helps fight infection
and removes and destroys worn-out red blood cells. Red blood cells are cells that help carry
oxygen in the blood. The thymus gland is an organ located in the upper part of the chest and is
very important in producing substances that protect the body against disease. The tonsils are a
pair of oval masses at the back of the throat. Lymph nodes are small egg shaped structures in the
body that help fight against infection.

Lymphocytes are also made by fetal stem cells and develop in the bone marrow (a tissue that fills
the openings inside of bones). Fetal stem cells are the earliest type of cells that are present in the
body as a developing baby. Stem cells give rise to all of the different types of cells in the body.
After the lymphocytes are formed, they are released into the circulating blood.

ARE THERE DIFFERENT TYPES OF LYMPHOCYTES?

Yes. There are two types of lymphocytes. One type of lymphocyte is known as a T cell. The
other type is known as a B cell. T cells and B cells differ in function and the molecules that are
on their surface also differ. A molecule is a combination of atoms. An atom is the smallest part
of a substance that can exist alone or in combination with something else. See the next two
sections for a description of B cells and T cells.

WHAT IS A T CELL?

T cells (also known as T lymphocytes) are types of lymphocyte that circulate through the thymus
gland and have turned into cells known as thymocytes (cells that have developed in the thymus
gland). The thymus gland is an organ located in the upper part of the chest and is very important
in producing substances that protect the body against disease. When thymocytes are exposed
to antigens (substances in the body, such as those present on the surface of bacteria, that can
produce a defensive reaction by the body), they rapidly divide and produce large numbers of new
T cells that are sensitive to that type of antigen. More than 80% of lymphocytes in the circulating
blood are T cells.

There are two main groups of T cells. One group of T cells are called "killer cells" (also known
as cytotoxic T cells) because they produce chemical substances known as lymphokines that are
essential in helping the B cells (see next section) destroy foreign substances. Like B cells (as is
described in the next section), T cells are sensitized and stimulated to respond to certain antigens
present on invading microorganisms or abnormal cells. Another group of T cells are called
helper T cells. Helper T cells assist the killer T cells in performing their activities and help
protect the body against diseases in other ways.

T cells also appear to play an important role in the body's response to the spreading of cancer
cells. Cancer is a group of diseases in which symptomsare due to an abnormal and excessive
growth of cells in one of the body organs or tissues. The process of the T cells protecting the
body is known as cellular or cell-mediated immunity.

T cells reproduce through a process known as mitosis, in which the cells split in two. In mitosis,
each cell contains an exact copy of the chromosomes in the original cell. Chromosomes are
structures in a person's cells that contain proteins and a substance known as DNA (an
abbreviation for deoxyribonucleic acid). DNA is a chain of many connected genes. Genes
are units of material contained in a person's cells that contain coded instructions as for how
certain bodily characteristics (such as eye color) will develop.
WHAT IS A B CELL?

B cells (also known as B lymphocytes) are types of lymphocytes that circulates in the blood in an
immature (not fully developed) form. About 10% of lympocytes that circulate in the blood are B
cells. B cells produce proteins known as antibodies that are then inserted into the area that
immediately surround the cytoplasm (a gooey substance that fills up a cell). Antibodies attach to
foreign proteins in the body known as antigens that are found on the surface on certain
microorganisms. A microorganism is a tiny organism made of one cell that is usually too small
to be seen without using a microscope.

As an example of the above, some antibodies help fight against bacteria because bacteria
commonly contain many antigens. When the antibodies attach to the antigens on the
microorganism, this starts a process that lead to the death of the microorganism. This process of
the B cells protecting the body is known as humoral immunity, because the B cells release the
antibodies into the fluids (also known as humors) of the body. B cells also reproduce through a
process known as mitosis (see the last section for a description). When the B cells divide, each
cell has identical copies of antibodies on their surface.

Sometimes an immature B cell is exposed to an antigen that characterizes a single class of

microorganisms. An example of microorganisms would be bacteria. When the B cell is exposed
to such antigens, it becomes activated and travels to the spleen or the lymph nodes. The spleen is
an organ next to the stomach that helps fight infection and removes and destroys worn-out red
blood cells. Lymph nodes are small egg shaped structures in the body that help fight against
infection. When the B cells reach the spleen and the lymph nodes under such conditions, they
change into plasma cells and memory cells.

The plasma cells make and release antibodies. The memory cells do not release antibodies but
they "remember" antigens they were exposed to in the past so they can deal with them in a
quicker way when exposed to these antigens in the future. When exposed again to one of
these antigens the memory cells turn into plasma cells and release antibodies to fight off
the antigens. This is how vaccines (preparations given to protect the body against infections)
work. That is, vaccines expose the body to certain types of antigens so that the memory cells can
be prepared for them if encountered in the future and fight against them quickly. Memory cells
can survive in the body for many years.

WHAT PERCENT OF WHITE BLOOD CELLS ARE LYMPHOCYTES?

Approximately 15% to 40% of white blood cells are lymphocytes. It is important to keep in mind
that the ranges mentioned above will be different depending on the machine used to do the blood
test. Always use the normal range printed on the lab report to decide what range is normal.

WHAT CAN CAUSE THE LEVEL OF LYMPHOCYTES TO BE TOO HIGH?

There are many possible causes for an abnormally high lymphocyte count. A lymphocyte level
that is more than 40% is considered to be abnormally high. Some basic causes of a high
lymphocyte count are the flu and the chickenpox. Other causes of a high lymphoocyte level
include tuberculosis, mumps, rubella, varicella, whooping cough, brucellosis, and herpes
simplex. A brief description of these conditions are listed below:

Tuberculosis is a type of infection that usually affects the lungs. Mumps is a type of virus that
occurs suddenly, mainly in children, and usually causes the appearance of swelling in the face.
Rubella is type of virus infection that affects both children and adults. Whooping cough is a type
of infection that causes a cough and a whooping sound when breathing in. Brucellosis is a rare
type of bacterial infection that is transmitted from animals, such as cows, goats, and pigs. Herpes
simplex is a virus that usually causes flu-like symptoms and cold sores.

Acute lymphoblastic leukemia (ALL) and chronic lymphocytic leukemia (CLL) cause increases
in lymphocytes. Leukemia is a type of cancer in the blood in which bone marrow (a tissue that
fills the openings of bones) is replaced by early forms of white blood cells. Cancer is a group of
disease in which symptoms are due to an abnormal and excessive growth of cells in one of the
body organs or tissues. ALL is a type of leukemia in which there are too many immature (not
fully developed) white blood cells called blasts that are produced by the bone marrow (a tissue
that fills the openings of bones). One type of blast present in ALL is the lymphoblast, which is an
immature lymphocyte. CLL is a type of leukemia characterized by the presence of too many
mature lymphocytes.

Other conditions that can cause an abnormally high lymphocyte count include mononucleosis,
hepatitis, toxoplasmosis, and cytomegalovirus. Mononucleosis is suddenly occurring virus
infection that is characterized by an abnormal increase in a type of white blood cell in the blood.
Hepatitis is an infection of the liver that causes liver inflammation. The liver is the largest organ
in the body and is responsible for filtering (removing) harmful chemical substances, producing
important chemicals for the body, and other important functions. Toxoplasmosis is a type of
infection of birds, reptiles, and other animals that can also occur in humans. Cytomegalovirus is
a type of virus that usually causes infections in the eye and the stomach area.

Certain medications can also lead to a high lymphocyte count. Two such medications are
Dilantin and mephenytoin, which are both anti-seizure medications Seizures are involuntary
muscle movements due to overexcitement of nerve cells in the brain. High lymphocyte levels
also occur after blood transfusions. A blood transfusion is a procedure in medicine in which
blood (usually from another person) is introduced into someone's bloodstream.

WHAT CAN CAUSE THE LEVEL OF LYMPHOCYTES TO BE TOO LOW?

There are many possible causes for an abnormally low (less than 15%) lymphocyte count. Since
lymphocytes are made in the bone marrow (a tissue that fills the openings of bones), if not
enough bone marrow is produced or the activity of the bone marrow decreases, an abnormally
low lymphocyte count can occur. Bone marrow destruction occurs in aplastic anemia. Aplastic
anemia is a condition in which the there is an abnormal decrease in the cells that make up blood
(such as white blood cells) because the bone marrow is not working properly to make these cells.
Aplastic anemia can cause an abnormally low lymphocyte count.
People with AIDS (Acquired Immune Deficiency Syndrome) often have an abnormally low
lymphocyte count. AIDS is a decrease in the effectiveness of the body's immune (defense)
system that is due to infection from a virus known as HIV (human immunodeficiency virus).
Tumors (tissues that grow more rapidly than normal) can cause an abnormally low lymphocyte
count.

Steroids can cause an abnormal decrease in the lymphocyte account. Steroids are any of a large
number of hormone substances with a similar and basic chemical structure. Hormones are natural
chemicals produced by the body and released into the blood that have a specific effect on tissues
in the body. An overactive adrenal cortex can also cause an abnormal decrease in the lymphocyte
count. The adrenal cortex is the outer part of an important organ (the adrenal gland) that
produces hormones that are essential for the body to regulate itself.

Some disorders that affect the nerves in the body can cause the lymphocyte level to be too low.
Examples are multiple sclerosis, myasthenia gravis, and Guillain-Barre syndrome. Multiple
sclerosis is a condition in which people develop multiple areas of abnormal patches (also known
as plaques or sclerosis) in the brain and/or spinal cord (depending on the stage of the illness).
Myasthenia gravis is a type of disorder in which the muscles get weak and tire easily as a result
of poor conduction (transmission) of nerve impulses. Guillain-Barre syndrome is a rare disorder
that causes weakness in the arms and legs because of nerve damage.

WHAT ELSE ARE LYMPHOCYTES CALLED?

Lymphocytes are also known as lymph cells, lymphocysts, and lympholeukocytes.

WHAT IS THE ORIGIN OF THE TERM, LYMPHOCYTE?

Lymphocyte comes from the Latin word "lympha" meaning "spring water," and the Greek word
"kytos" meaning "cell." Put the two words together and you have "spring water cell."

What Causes Lymphocytopenia?

In general, lymphocytopenia (a low lymphocyte count) occurs because:

 The body doesn't make enough lymphocytes.

 The body makes enough lymphocytes, but they are destroyed due to an abnormal
condition.
 The lymphocytes get stuck in the spleen or lymph nodes.

A combination of these factors also may cause a low lymphocyte count.

A number of diseases, conditions, and factors can cause the problems that lead to a low
lymphocyte count. These conditions can be inherited (passed from parents to children), or they
can develop at any age.

Exactly how each disease, condition, or factor affects your lymphocyte count isn't known.
Sometimes, people have low lymphocyte counts with no underlying cause.

Acquired Causes

A number of acquired diseases, conditions, and factors can cause lymphocytopenia. Examples
include:

 Infectious diseases, such as AIDS, viral hepatitis, tuberculosis, and typhoid fever
 Autoimmune disorders, such as lupus
 Steroid therapy
 Blood cancer and other blood diseases, such as Hodgkin's disease andaplastic anemia
 Radiation and chemotherapy (treatments for cancer)

Inherited Causes

Certain inherited diseases and conditions can lead to lymphocytopenia. Examples include
DiGeorge anomaly, Wiskott-Aldrich syndrome, severe combined immunodeficiency syndrome,
and ataxia-telangiectasia. These inherited conditions are rare.

What Are Lymphocytes?

Lymphocytes are a type of white blood cell that's responsible for protecting the body against
bacterial and viral infections. They make up anywhere from fifteen to forty percent of the total
white blood cells that circulate in the bloodstream. The two main types of lymphocytes are T
cells and B cells and both help to fight off infection and play a role in stopping the growth of
cancers. B cell lymphocytes are the special cells that produce infection fighting antibodies. For
this reason, people with a decreased lymphocyte count may be more susceptible to certain types
of infections. There is also a subtype of T cell known as a natural killer cell that helps to destroy
cells infected by viruses as well as tumor cells. 

How is a Low Decreased Lymphocyte Count Detected?

When a routine blood cell panel is drawn, the lab performs a differential count which shows the
proportion of each type of white blood cell along with the total number of white cells present in
the sample. There's a range established for what's normal and the values can be compared against
these values. When lymphocyte counts are below fifteen percent of the total white blood cell
count, it's considered to be an abnormally low reading.

What Causes a Decrease in Lymphocytes?

One of the most common causes is an underlying viral infection. Viral infections can cause a
temporary drop in lymphocytes as more of them are drawn away to fight the infection, but the
lymphocyte count usually returns to normal within weeks after the infection is resolved. One of
the more serious viral causes of a decrease in lymphocytes is infection with the HIV virus. In this
case, a low lymphocyte count is very likely to lead to infection with "opportunistic" pathogens,
ones that typically don't cause disease in a normal person. 

Another Reason for a Decrease in Lymphocytes

Lymphocytes are made in the bone marrow which means that when the bone marrow isn't
functioning properly, lymphocyte counts can drop. This can occur in a condition known as
aplastic anemia. There are also certain

inherited conditions where the body doesn't make enough immune cells, resulting in a decrease
in lymphocytes.

Some Drugs Can Decrease Lymphocytes

If you've recently taken steroids or had radiation or chemotherapy, it can cause lymphocyte
counts to drop temporarily. People who undergo chemotherapy, radiation, or steroid treatment
are more susceptible to infection due to their lowered lymphocyte count. Usually this all reverses
upon stopping the treatment.
Other Causes of a Decreased Lymphocyte Count

Some neurological diseases such as multiple sclerosis and Guillain-Barre syndrome cause
lymphocyte counts to drop, as can autoimmune problems such as rheumatoid arthritis.. Some
cancers can also cause a decreased lymphocyte count, usually ones involving the blood or lymph
system.

The Bottom Line?

A decreased lymphocyte count may be a temporary response to a virus or can result from use of
medications such as steroids. In other cases, it can indicate a more serious infection or an
underlying autoimmune disease or cancer. If the lymphocyte count is only slightly below normal,
your doctor may want to repeat it in a few weeks as long as you're having no other symptoms. If
it persists, you may need further tests. Be sure to follow up with your doctor if you have a
decreased lymphocyte count as you may be at higher risk of infection.