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In adults, absolute lymphocytosis is present when the absolute lymphocyte count is greater than 4000 per microliter, in older children greater than 7000 per microliter and in infants greater than 9000 per microliter. Lymphocytes normally represent 20 to 40% of circulating white blood cells.ymphocytosis is usually detected when a complete blood count is routinely obtained. The absolute lymphocyte count (ALC) can be directly measured by flow cytometry, or calculated by multiplying the total white blood cell (WBC) count by the percentage of lymphocytes found in the differential count.
Lymphocytosis is increase in the lymphocyte counts to what is normal for age. Lymphocyte count is highest at birth and falls with age. Normal lymphocyte counts in adults is 1000 to 4800 cells/mm 3. Causes of Lymphocytosis. Lymphocytosis may be reactive (see table below) or due to a malignancy. Reactive lymphocytosis is polyclonal. Lymphocytosis due to malignancy is monoclonal. The most common cause of reactive lymphocytosis is infectious mononucleosis due to Epstein-Barr virus infection. Reactive lymphocytosis may be seen in other viral infections, drug hypersensitivity, thymoma and after splenectomy. Persistent polyclonal B cell lymphocytosis is a condition found in middle aged women who smoke. Monoclonal B cell lymphocytosis and chronic lymphocytic leukaemia are the commonest causes of primary lymphocytosis.