Case 100 (part C) – update 1

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:

Case 100 part c

A haematologist contacts you as the laboratory have performed flow cytometry:

Case 100 flow1Case 100 flow3Case 100 flow4Case 100 flow5

Questions

  • What is the most likely diagnosis?
  • What questions are you going to ask?
  • What test can confirm the diagnosis?

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