Category Archives: Laboratory morphology

Case 98 – part 1 – update 1

We have found our patient has a lymphocytosis with mild anaemia and mild thrombocytopenia. Blood film show lymphocytosis with mature lymphocytes and smear cells. We have some flow results. What do these show? What is our diagnosis? Would you like … Continue reading

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Case 97 – update 2

The bone marrow aspirate did appear to show an excess of Plasmacytoid and lymphoplasmacytoid cells. Immunophenotype results: Abnormal population: Kappa restricted B cell population = 18% of total nucleated cells. Immunophenotype: CD19+, CD5 negative, CD23 negative/wk, CD10 negative, CD103 negative, … Continue reading

Posted in Laboratory morphology, Lymphoma, Myeloma/paraproteins, Related to other specialities | Tagged , , , , , ,

Case 96 – update 3

The blood film has been reported: – leukocytosis with neutrophilia and monocytosis, there is left shift and toxic granulation and vacuolation. Occasional primitive cells ~ 2%. No nucleated RBCs. The appearances might be reactive/infection related, and infection as well as … Continue reading

Posted in Bone marrow failure, Laboratory morphology, Myeloproliferative neoplasm, Paediatric haematology | Tagged , , , , , , , , , , , ,

Case 96 – update 2

An USS abdomen has been performed which confirms mild hepato-splenomegaly. CXR was reported as normal. Faecal elastase, TTG, TFTs, ILGF1 all normal. You phone the haematology registrar to look at the blood film in view of the abnormal FBC. Questions: … Continue reading

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Case 95 – summary

Thankyou for all your help this week. This week we had a look at mantle cell lymphoma (MCL). MCL is a type of none Hodgkin’s lymphoma, and comprises between 3 and 10% of NHL, and often has features of both … Continue reading

Posted in Chronic leukaemia, Laboratory morphology, Lymphoma | Tagged , ,

Case 95 – update 1

So we have found our patient has a lymphocytosis on repeat bloods, we have no historical results. He denies and weight loss, sweats or tiredness. On examination you can feel an enlarged spleen 4cm below the costal margin, but you … Continue reading

Posted in Chronic leukaemia, Laboratory morphology, Lymphoma | Tagged ,

Case 90 – summary

We started with a 74 year old gentleman who was admitted with weight loss, fatigue and change in bowel habit. A mass in the right iliac fossa was palpated and a colonic malignancy was suspected. He had thrombocytosis with microcytic indices … Continue reading

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Case 90 – update 4

Here is the antibody panel. Can you identify the antibody?  

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Case 90 – update 3

Our patient is one week post two units of blood and his haemoglobin is back to baseline and has hyperbilirubinaemia. LDH is elevated and haptoglobins are absent. Blood film shows spherocytes. Here is the antibody screen Questions (For fun!) can … Continue reading

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Case 89 – update 1

Thanks for everyones contributions so far. Further information now available as requested by yourselves: Patient decline over past 6 months – 0.5 stone weight loss, no night sweats / fevers. Marked lethargy and generally feeling ‘achey’. Poor appetite but no … Continue reading

Posted in Anaemia, Laboratory morphology, Myeloproliferative neoplasm | Tagged , , , ,

Case 88 – summary

Morphology week summary. Case A     Our followers were correct in suggesting these were plasma cells, one of which is binucleate on the second picture.  Thrombocytopenia was also noted.  This would be in keeping with a diagnosis of plasma … Continue reading

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Case 88 – part E

Last slide of the week. Spot diagnosis – patient presented with a vasculitis

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Case 88 – parts C and D: update

Flow cytometry results. Not true to life I know but just for a bit of fun and test our morphology and flow skills….. The following results are for our two patients- what is the diagnosis for each? Which results goes … Continue reading

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Case 88 – parts C and D

You are reviewing the blood film tray and a further two patients are noted to have lymphocytosis Case C Hb 96 g/L WCC 34 (10^9/L) Case D Hb 100 g/L WBC 23 (10^9/L) Can you describe the findings? Do they … Continue reading

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Case 88 – part B: update

As requested by some followers Flow cytometry : CD5 + CD23 – SmIg strong FMC7 ++ CD20 ++ CD22 ++ CD19+ CD79b ++ CD200 ++ CD10- Cyclin D1 expression (11:14)(q13:32)negative Splenomegaly noted on examination, with no evidence of lymphadenopathy.   … Continue reading

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Case 88 – part B

84 year old man Hb 111 WBC 24 Describe the findings on the blood film What further clinical information would you wish to know? further investigations?  

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Case 88 – part A

This week we are going to do some quick fire morphology cases. Cases will be centered around a blood film, then added questions based on the diagnosis our followers come up with. Please feel free to add interesting pictures of … Continue reading

Posted in Laboratory morphology, Myeloma/paraproteins | Tagged , ,

Case 86 – part C2

Thanks for your help with this short case. We examined this blood film of an unwell female: The most striking abnormality is red cell fragmentation. This can be seen in: AIHA/Evans’ syndrome DIC Pregnancy-associated (HELLP, pre-eclampsia, malignant hypertension, fatty liver of … Continue reading

Posted in Laboratory morphology, Platelet disorders, Thrombosis, Transfusion | Tagged , , , , ,

Case 86 – part 3A

A 32 year old female presents with headaches, visual disturbance and fever. Hb 92g/L MCV 99fl Platelets 38×109/l WCC and differential – mild neutrophilia Questions Name some features of the blood film? What are the differential diagnosis? What further investigations … Continue reading

Posted in Laboratory morphology, Thrombosis, Transfusion | Tagged , , , , ,

Case 86 – part B2

Thanks for joining in with this short case. We reviewed the blood film of an 82 year old. The FBC was done for diabetes monitoring. There was no recent transfusion and no new medications. The film showed red cell agglutination(3) … Continue reading

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