The patient is referred to Haematology and a CT scan is requested.  This confirms splenomegaly with some enlarged mesenteric lymph nodes also identified.

A bone marrow biopsy is organised for the following day.  Unfortunately, this is a dry tap and only a trephine biopsy can be taken.

Do the results of the CT help aid the differential diagnosis?

What causes a dry tap on bone marrow aspirate?

What are you expecting to find on the bone marrow trephine?