Case 132 – Update 5!

Thank you fo everyone’s ongoing input.

Our patient had been stable on acalabrutinib for 20 months following a complete remission (complete resolution of his lymphocytosis (after 13 months), resolution of his cervical lymphadenopathy and cytopenias).

However when he attends clinic he mentions that he has not been well. Over the past month he has become lethargic, lost weight and developed night sweats. He has no palpable lymphadenopathy.

FBC:

Hb 118, Plts 162, WCC 15, neuts 3.1, lymphocytosis 10.2.

Questions:

  1. What investigations would you want to perform?
  2. What is the possible differential diagnosis?

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