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Category Archives: Chronic leukaemia
Case 80 – summary
This week we discussed a 65 year old gentleman who was about to undergo curative surgery for gastric carcinoma. His admission blood tests showed pancytopenia and monocytopenia. The differential diagnosis of pancytopenia includes: Haematological malignancy e.g. myelodysplasia or infiltration … Continue reading
Case 80 – update 3
The immunophenotype was: CD20+, CD79b+, CD22+, CD5 negative, FMC7+, CD103+, CD11c+, CD25+, CD10 negative, CD38 negative, lambda sIg+ This is consistent with hairy cell leukaemia. If further immunophenotypic evidence is required additional stains on the trephine can be undertaken (e.g. … Continue reading
Case 80 – update 2
The blood film showed a population of lymphoid cells with ‘hairy projections’. There was absolute monocytopenia. Both of these are consistent with a diagnosis of hairy cell leukaemia. However, hairy cell leukaemia variant and other low grade lymphoma may have … Continue reading
Case 80 – update 1
Our patient has pancytopenia. On examination there is no specific findings. There is no palpable lymphadenopathy or hepatosplenomegly. There is no rash or gum infiltration. There are no features of chronic liver disease. However review of recent imaging has noted … Continue reading
Case 80 – the beginning
Welcome to our new case. You are the surgical house officer reviewing a new elective admission. He is 65 years old gentleman and has been admitted for resection of a gastric cancer. He is an ex-smoker, takes ramipril for hypertension … Continue reading
Posted in Chronic leukaemia, Lymphoma
Tagged cancer, Liver disease, pancytopenia
Case 78 – Summary
Thanks for your help this week. We had a case of T-LGL associated with rheumatoid arthritis. In our case her planned surgery was postponed. She was given GCSF and responded to this and this was used pre operatively for optimisation. … Continue reading
Case 78 – update 2
Flow results are back: CD 3 pos, CD 8 pos, CD 4 neg, CD 56 neg, CD 16 neg, CD 5 neg, CD7 wk/variable, TCR alpha/beta pos PCR TCR studies confirm clonality A Diagnosis of T Large Granular Lymphocytic leukameia is … Continue reading
Case 78 – Update 1
Thank for all the suggestions so far. We followed your advice and the lady has had her surgery postponed and we have established the following: History: Chronic anaemia since 2011 stable at around 90. No history of bleeding/Malena No weight … Continue reading
Posted in Chronic leukaemia
Tagged autoimmune disease, neutropenia, rheumatoid arthritis
Case 78 – the Beginning
A 72 year old lady has attended pre- assessment clinic for an elective hip replacement and had routine bloods taken. Blood results: Hb 93, MCV 97, Plt 220, Wcc 7.5, Neu 0.9, lymph 6.0. Normal Liver and Renal function Blood … Continue reading
Posted in Chronic leukaemia
Tagged autoimmune disease, Blood film, morphology, neutropenia, rheumatoid arthritis
Case 72 – case B
A 40 year old gentleman present with the following FBC: WCC 2.9×109/L (4-11) Neuts 0.9×109/L (1.7-7) Lymphocytes 1.4×109/L (1.5-4.5) Monocytes 0.2×109/L (0.2-1) Eosinophils 0.3×109/L (0-0.5) Basophils 0.1×109/L (0-0.1) Hb 55g/L (130-180) MCV 88fL (82-98) Platelets 31×109/L (150-450) His bone marrow … Continue reading
Posted in Chronic leukaemia, Lymphoma
Tagged Hairy cell leukaemia, morphology, pancytopenia, Trephine
Case 59 – summary
This case was focussed on the investigation of splenomegaly, rather than the ultimate diagnosis (though we did make one). So what did we learn? DEFINITION This varies, but 14cm is generally considered to be the upper limit of normal. DIFFERENTIAL … Continue reading
Posted in Chronic leukaemia
Tagged pancytopenia, Splenectomy
Case 59 – update 2
Mr Q has become pancytopenic over the last two years. His spleen remains palpable and is clinically larger – approximately 8 cm below the costal margin. His bone marrow aspirate was acellular and somewhat difficult to obtain. The trephine looks … Continue reading
Case 59 – update 1
Welcome back. The learning points from our first section are outlined below. If you want to skip to the bottom to find out what is now happening with the patient and respond to the next question, please do! The case … Continue reading
Case 59 – the beginning
Welcome to case 59. Today we’re reviewing Mr Q, who was referred to the outpatient clinic with the following letter: ‘Dear Colleague, Please see Mr Q (DOB 01/01/1945) who was noted to have splenomegaly (16cm) on a recent ultrasound scan. … Continue reading
Case 55 – Summary
This week we met Mr Jones, a 77 year old man who had an abnormal result when he attended his GP for annual well man bloods. His FBC revealed a moderate thrombocytopenia, a slight lymphocytosis and a normochromic anaemia. When … Continue reading
Posted in Chronic leukaemia, Lymphoma
Tagged chemotherapy, elderly, Flow cytometry, Lymphocytosis
Case 55 – Update
The film for this patient showed moderate sized lymphocytes with frequently clefted nuclei and nucleoli. There were no smear cells. The laboratory staff decided to send the specimen for flow cytometry and obtained the following results: CD5+ CD10- CD19+ CD20+ … Continue reading
Posted in Chronic leukaemia, Lymphoma
Tagged chemotherapy, elderly, Flow cytometry, Lymphocytosis
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Case 55 – the beginning
Good evening. This week we’re going to work together to manage an elderly patient with a leukocytosis. Mr Jones is 77 and attends his GP practice for his annual ‘birthday bloods.’ The following results were obtained: Hb 110 g/dl WCC … Continue reading
Posted in Chronic leukaemia, Lymphoma
Tagged chemotherapy, elderly, Flow cytometry, Lymphocytosis
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Case 54 – case A
This week we are going to look at a range of short cases, some of which are morphology based, and most will include MCQ questions. The discussion does not have to be limited to the basic answer – please feel … Continue reading
Posted in Chronic leukaemia, Laboratory morphology, Lymphoma
Tagged Flow cytometry, Lymphocytosis, morphology
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Case 52 – summary
Our case was based on a 34 year old lady with a new diagnosis of CML. Diagnosis CML in a proportion of patients is diagnosed on routine blood tests prior to onset of symptoms. However, symptoms can include: lethargy shortness … Continue reading
Posted in Chronic leukaemia, Myeloproliferative neoplasm
Tagged BCRABL, CML, splenomegaly, Thrombocytosis, TKI
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