Our patient has a mildly elevated lymphocyte count and this is persistent on repeat. In the absence of reactive causes the most likely explanation is a low grade lymphoproliferative neoplasm such as CLL. After a period of monitoring the patient’s lymphocyte count rises:
- Hb 140g/l (115-165)
- MCV 95fl (82-98)
- WCC 30.4×109/l (4-11)
- Neutrophils 5.7×109/l (1.7-7.5)
- Lymphocytes 23.3×109/l (1.5-4.5)
- Platelets 232×109/l (150-450)
Here is the film:
A haematologist contacts you as the laboratory have performed flow cytometry:
- What is the most likely diagnosis?
- What questions are you going to ask?
- What test can confirm the diagnosis?
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