Category Archives: Lymphoma

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

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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

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Case 100 (part C) – the beginning

You are in a GP surgery and are asked to perform a full blood count on a 60 year old male who is awaiting a knee replacement for osteoarthritis. He has a past history of glaucoma, hypertension and a myocardial … Continue reading

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Case 97 – Summary

This week we looked at a neuropathy presenting via the neurology team associated with a plasma cell dyscrasia. This area of haematology is often challenging! The diagnosis can be difficult and even after diagnosis there is a lack of evidence … Continue reading

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Case 97 – update 3

Thanks for your help so far with this case. so far we know our patient is a 54 year old male who presented to clinic with distal sensory loss and a broad based gait which has been slowly progressing over … 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

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Case 97 – update 1

Thanks for your help so far The neurology team contact you as they have the results of the Nerve conduction studies they performed a few weeks ago these show “prolonged conduction velocities consistent with demyelination in an axonal loss pattern” … Continue reading

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Case 97 – the beginning

Welcome to another #TeamHaem case You are in the Haematology new patient clinic and receive a letter from the local Neurology team asking you to assess a 54 year old male who has an Ig M kappa paraprotein of 6g/dl … 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

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Case 95 – update 2

We have monitored our patient for a year. Unfortunately at his most recent appointment he has begun to complain of weight loss of 7kg, drenching night sweats and fatigue. What would you want to do next? Are there any investigations … Continue reading

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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

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Case 95 – the beginning

Welcome to our new case! This week we start in GP. We have a 59 year old gentleman who A&E have asked you to follow up as he was found to have a slight lymphocytosis on some bloods that were … Continue reading

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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 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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Case 86 – part B1

An 82 year old gentleman has a routine blood count for diabetes monitoring. This is the blood film.   Questions: What do you see on the blood film? What questions do you want to ask the patient? Any further investigations? … Continue reading

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