Category Archives: Lymphoma

Case 72- summary

Answers A – hereditary elliptocytosis B – hairy cell leukaemia C – metastatic prostate cancer Case A The first case, we started with something relatively straightforward: This was a blood film of a 21 year old pregnant women who was … Continue reading

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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

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Case 69 – part 3 – summary

During this short case we looked at serum protein electrophoresis. This showed a band in the gamma region and immunofixation confirmed a IgM kappa paraprotein. IgM paraproteins are commonly associated with MGUS, low grade lymphoma and rarely myeloma. Typically IgM … Continue reading

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Case 69 – part 3 – the beginning

Thanks for contributing! Please use #TeamHaem in your reply on Twitter!   A 69 year old gentleman presents to his GP with headache and visual blurring. Giant cell arteritis is suspected as the ESR is 120mm/hr. A serum protein electrophoresis … Continue reading

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Case 65 – summary

Our case concentrated on presentation, investigation and management of DLBCL.   Case summary This 42 year old gentleman had presented with a history of B-symptoms and palpable lymphadenopathy.  Bloods tests revealed an acute kidney injury highlighting the need for urgent … Continue reading

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Case 65 – update 2

Histology confirms DLBCL – MYC, BCL2 and BCL6 negative.  He commences methylpred once the provisional histology is available and is managed for tumour lysis risk.  He is then consented to CHOP- R chemo.  He asks ‘will the chemotherapy cure the … Continue reading

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Case 65 – update 1

The GP organises the blood requested urgently. Hb 110 wbc – normal plt – normal blood film – normocytic anaemia   Urea – 18 mmol/L creat- 320 mmol/L LDH – 765   You admit the patient urgently for staging CT. … Continue reading

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Case 65 – the beginning

a 42 year old gentleman attends his GP with a 2 month history of weight loss, night sweats and palpable inguinal lymph nodes. Your are contacted as the haematology registrar on call.  What other information do you need? Investigations? Time … Continue reading

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Case 57 – summary

Thankyou for all your input with this case! This week we looked at classical Hodgkin’s disease. Our patient was initially diagnosed with stage 2B early unfavourable Hodgkin’s disease. Following 4 cycles of ABVD and radiotherapy he was in remission.  Unfortunately … Continue reading

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Case 57 – update 2

Our patient has been diagnosed with stage 2B classical Hodgkin’s. Using the German Hodgkin’s study group criteria he has early unfavourable disease. We followed the German approach to treatment and he had 4 cycles of ABVD and radiotherapy to the … Continue reading

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Case 57 – update 1

Our patient has been referred to the haematology team. He presented with a left sided inguinal node which he noticed around 4 weeks ago, this had been enlarging and was around 2x3cm when he initially presented. He has been feeling … Continue reading

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Case 57 – the beginning

Welcome to our new case!This week we start in a gp practice. A 32 year old gentleman attends with a left sided groin lump which he feels is enlarging. What other information would you like to ask in the history? … Continue reading

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Case 56 – Summary

This weeks case dealt with the presentation of a rare lymphoma. James was found to have an NK cell lymphoma of the sinuses with a single cervical lymph node. He had an IPI score of 0 and no other co-morbidity. … Continue reading

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Case 56 – update 3

IPI score is calculated as 0 and there is evidence this may be prognostic to some extent in NK lymphomas. The MDT had no trials available so felt SMILE (Dexamethasone, methotrexate, Ifosfamide, L-Asparaginase and Etoposide) chemotherapy was a suitable option, … Continue reading

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Case 56 – update 2

The biopsy shows an angiocentric distribution of atypical lymphoid cells penetrating the blood vessel walls.The immunophenotype shows CD2 +, Surface CD 3 -, Cytoplasmic CD3 + and CD 56 + cells. James’ biopsy confirms a diagnosis of Nasal NK/T cell … Continue reading

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Case 56 – update 1

So far we have found out James has not been abroad, he is a lifelong non-smoker and has had no previous procedures. He has no past medical history and has no regular medications. Tests: Wcc 13, Hb 130, plt 260, … Continue reading

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Case 56 – the beginning

James a 48 year old painter presents to his GP with facial pain over his right cheek and a blocked nose with rhinorrhoea. James is given antibiotics for probable sinusitis. Three weeks later his symptoms are worse; he has constant … Continue reading

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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

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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

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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

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