Category Archives: Lymphoma

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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Case 80 – summary

This week we discussed a 65 year old gentleman who was about to undergo curative surgery for gastric carcinoma. His admission blood tests showed pancytopenia and monocytopenia.   The differential diagnosis of pancytopenia includes: Haematological malignancy e.g. myelodysplasia or infiltration … Continue reading

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Case 80 – update 3

The immunophenotype was: CD20+, CD79b+, CD22+, CD5 negative, FMC7+, CD103+, CD11c+, CD25+, CD10 negative, CD38 negative, lambda sIg+ This is consistent with hairy cell leukaemia. If further immunophenotypic evidence is required additional stains on the trephine can be undertaken (e.g. … Continue reading

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Case 80 – update 2

The blood film showed a population of lymphoid cells with ‘hairy projections’. There was absolute monocytopenia. Both of these are consistent with a diagnosis of hairy cell leukaemia. However, hairy cell leukaemia variant and other low grade lymphoma may have … Continue reading

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Case 80 – update 1

Our patient has pancytopenia. On examination there is no specific findings. There is no palpable lymphadenopathy or hepatosplenomegly. There is no rash or gum infiltration. There are no features of chronic liver disease. However review of recent imaging has noted … Continue reading

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Case 80 – the beginning

Welcome to our new case. You are the surgical house officer reviewing a new elective admission. He is 65 years old gentleman and has been admitted for resection of a gastric cancer. He is an ex-smoker, takes ramipril for hypertension … Continue reading

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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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