So we have found our patient has a lymphocytosis on repeat bloods, we have no historical results.
He denies and weight loss, sweats or tiredness.
On examination you can feel an enlarged spleen 4cm below the costal margin, but you can not palpate any lymphnodes.
A repeat fbc has been done and results show
- Hb 137
- Plt 175
- Wcc 23
- Neut 5
- Lymphocytes 16.5
- HIV negative
- EBV IgG positive, IgM negative
- CMV IgG positive, IgM negative
He has been referred to haematology with those results.
Blood film shows
Angular, pleomorphic lymphoid population with v high NC ratio, clumped chromatin, and occasional nuclear clefts. About 1/3 contain nucleoli
Flow cytometry has been requested
Here are some of the results.
- What can you tell from these results? What are the possible diagnosis?
- What would do next? Are there any other tests you would want to organise?
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