Our patient has pancytopenia. On examination there is no specific findings. There is no palpable lymphadenopathy or hepatosplenomegly. There is no rash or gum infiltration. There are no features of chronic liver disease. However review of recent imaging has noted splenomegaly at 16cm. He has not received any recent chemotherapy.
After discussion with the surgical team it is felt that delaying the surgery is in the the best interests of the patient as it is not life threatening. In emergency situations support with GCSF may be appropriate on a case by case basis depending on differential diagnosis.
A blood film is made and here are some pictures:
- What further investigations would you perform to find the cause of pancytopenia?
- Can the surgery safely proceed?
- What do you notice on the blood film?
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