Case 95 – update 1

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?

Join us on Twitter @TeamHaem and let us know what your thoughts are, what questions you have and what you want to do as we see this case evolve over the next week. Remember to use #teamhaem on all your posts to help us follow the case! 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.