Case 80 – update 1

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:

 

Questions

  • 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?

 

Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please join in the debate and learn about haematological problems along the way. The case will continue to  evolve over the coming week so keep checking #TeamHaem on Twitter for more information.

Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality.

TeamHaem are not a position of authority.  It is an educational platform to allow discussion and learning.

 

 

About TeamHaem

Online education and discussion about all things haematological
This entry was posted in Chronic leukaemia, Laboratory morphology, Lymphoma and tagged , , , , , , . Bookmark the permalink.