Category Archives: Chronic leukaemia

Case 52 – update 2

Great discussion so far regarding staging and options for treatment. Overall I think the consensus is to treat this lady with imatinib. The patient commences treatment and BCR-ABL1 shows a major molecular response at 18 months. At this clinic appointment … Continue reading

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Case 52 – update 1

This patient gives a history of palpitations for the past two days.  On questioning she has noted occasional night sweats, and describes some abdominal fullness, but otherwise is usually fit and well with no significant past medical history.  She is … Continue reading

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Case 52 – the beginning

A 34 year old female presents to A&E with a 2 day history of palpitations.   Full blood count shows: Hb 84 g/l (135-180) MCV 91 fl (78-100) MCH 29 pg (27-32) Plts 649 x10*9 (150-400) WCC 88 x10*9 (4-11) Differential … Continue reading

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Case 50 part 1 -summary

Thanks for all of the contributions. The marrow showed erythrophagocytosis. This can be a sign of autoimmune haemolytic anaemia. In particular it can be seen in paroxysmal cold haemoglobinuria. We were slightly mean and didn’t show the rest of the … Continue reading

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Case 50 part 1 – update

We were reviewing the marrow smear from an elderly gentleman with weight loss and macrocytic anaemia. Further results include: Reticulocyte count 276×10*9/L Bilirubin 54ug/L LDH 1056U/L DAT IgG 4+   The above is consistent with warm autoimmune haemolytic anemia. The … Continue reading

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Case 50 part 1 – the begining

This week we will be doing some short cases based around some pictures. Each case will last around 24-36 hours, so get in quick!  As always – the information is posted here and the discussion will be on Twitter. Follow … Continue reading

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Case 44 – summary

Chronic lymphocytic leukaemia Our case began with a blood film demonstrating small mature lymphocytes, and smear cells, which are findings typical of CLL. The flow cytometry confirmed this diagnosis with a CLL score of 5/5. CD5 + CD23+ Fmc7 negative … Continue reading

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Case 44 – update 2

The patient is referred to haematology.  On review you note he has widespread lymphadenopathy, splenomegaly and weight loss.  You decide to commence him on treatment. He has no past medical history and appears fit to undergo chemotherapy. You have requested … Continue reading

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Case 44 – update 1

Some of you have suggested requesting flow chrome try on the sample.  The results of this are; cd19+ cd5+ FMC7 weak cd23+ cd79b neg cd38 neg sIg weak what is your differential? The patient is a 52 year old gentleman. … Continue reading

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Case 44 – the beginning

Welcome to case 44! Share your thoughts on the following blood film. What other information would you wish to know following review of the film? What advice would you give to the referring clinical? Would you request any further investigations … Continue reading

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Morphology week – case 2

What would you report on this blood film? Diagnosis?

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Short case blood film – summary

Some great comments from #teamhaem, including: Hairy cells Howell Jolly bodies Ansiocytosis Nucleated red cells Ansiopoikilocytosis Rouleaux All of the above sound good to us.  Some of our followers rightly pointed out that one should not jump to a diagnosis … Continue reading

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Short case blood film – update 1

Below is the blood film from earlier… just higher power.  How would you describe it?  We’ll let you know what that patient had in the end!  Please reply on Twitter and include #teamhaem Please reply on Twitter and always include … Continue reading

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Short case blood film – the beginning

How would you describe this blood film?

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Case 12 – summary

Hairy cell leukaemia   Hairy cell leukaemia is a chronic lymphoid lymphoma of B-cells The hairy cells infiltrate the reticuloendothelial system and interfere with bone marrow function, resulting in bone marrow failure or pancytopenia.  They also infiltrate the spleen and … Continue reading

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Case 12 – update 6

The trephine shows the typical “fried egg cells” seen in hairy cell leukaemia.  The cells appear widely spaced due to abundant cytoplasm, with broad projections.   This is typical hairy cell which may be found on the peripheral blood film – although in … Continue reading

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Case 12 – update 5

Image size increased!!! what would you expect to find on immunohistochemistry? how would you manage this patient?  what are the options?

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Case 12 – update 4

The results you have all been waiting for!!! Can you describe this trephine biopsy?  Start with the basics! Can you make a diagnosis? If so how would you manage this patient?  any more investigations!

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Case 12 – update 3

The patient is referred to Haematology and a CT scan is requested.  This confirms splenomegaly with some enlarged mesenteric lymph nodes also identified. A bone marrow biopsy is organised for the following day.  Unfortunately, this is a dry tap and … Continue reading

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Case 12 – update 2

Results of the initial investigations: FBC 105 g/l WCC 6.0×10*9/l Platelet count 70 x10*9 MCV 82 FL HCT 0.39 Neutrophil 1.0 x10*9/l Lymphocytes 4.0×10*9/l Eosinophils 0.6×10*9/l Monocytes 0.2*10*9/l Basophils 0.1×10*9/l Large unstained cells 0.8×10*9 Small section of blood film shown above! U&Es … Continue reading

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