Category Archives: Laboratory morphology

Case 100 (part D) – summary

The patient had mild thrombocytopenia and has suffered epistaxis. Epistaxis is relatively common and therefore structural causes should also be looked into. This is especially so if the nose bleeds are unilateral. There is a wide differential of why someone … Continue reading

Posted in Inherited bleeding, Laboratory morphology, Paediatric haematology, Platelet disorders | Tagged , , , , , , , ,

Case 100 (part D) – update

You repeat the FBC and it shows similar results Hb 141g/l (130-180) MCV 89fl (82-98) WCC 7.5×109/l (4-11) Neutrophils 4.7×109/l (1.7-7.5) Lymphocytes 2.1×109/l  (1.5-4.5) Platelets 70×109/l (150-450) Coagulation screen – normal U&E/LFT – normal Blood film: Questions What is the … Continue reading

Posted in Inherited bleeding, Laboratory morphology, Paediatric haematology, Platelet disorders | Tagged , , , , , ,

Case 100 (part C) – summary

Our patient had a mild lymphocytosis. The differentials include: Reactive – especially viral illnesses Hyposplenism Smoking Polyclonal B cell lymphocytosis – binucleate lymphocytes with isochrome 3q Lymphoproliferative neoplasms such as CLL and other types of lymphoma In the first instance … Continue reading

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

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 … Continue reading

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

Case 100 (part B) – summary

Our patient had a mild neutrophilia. Neutrophilia can be seen in: Neonates Infection Especially bacterial (note marrow depletion may occur leading to neutropenia) Inflammation, autoimmune diseases etc. Acute gout Stressed states with high adrenaline e.g. myocardial infarction, exercise, acidosis, eclampsia, … Continue reading

Posted in Laboratory morphology, Myeloproliferative neoplasm, Related to other specialities | Tagged , , , , , , ,

Case 100 (part B) – update

Our patient’s neutrophilia/thrombocytosis is attributed to his chest infection. You advise to get a repeat FBC in one month but he forgets and goes to Spain for some ‘winter sun’. On return he has a repeat FBC: Hb 145g/l (115-165) … Continue reading

Posted in Laboratory morphology, Myeloproliferative neoplasm, Related to other specialities | Tagged , , , , ,

Case 99 – update 3

A bone marrow biopsy has been carried out: (see below) Aspirate shows erythroid hypoplasia but no dysplastic features. Cellularity is normal and megakaryocyte & granulocyte lineages are normal. For interest, also see Trephine IHC with Glycophorin-C staining – demonstrating reduced … Continue reading

Posted in Anaemia, Laboratory morphology, Paediatric haematology | Tagged , , , ,

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

Posted in Chronic leukaemia, Laboratory morphology | Tagged , ,

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

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

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

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

Case 90 – update 4

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

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

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

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

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

Posted in Chronic leukaemia, Laboratory morphology, Lymphoma, Myeloma/paraproteins | Tagged , , , , , , , , ,

Case 88 – part E

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

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

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

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