Category Archives: Lymphoma

Case 22 – update 2

The patient tells you that he has been feeling increasingly unwell for the last few weeks. He describes fatigue, headache and low grade fever over the last two weeks and put it down to a cold. On closer questioning he … Continue reading

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Case 22 – update 1

You have been asked to see a pancytopenic patient on the liver ward. Without knowing any more you have been working on a differential diagnosis as you climb the stairs to the ward. Suggestions from the team so far have … Continue reading

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Case 22 – the beginning

Welcome back to TeamHaem. This case will help you to develop your differential diagnosis and investigation of an abnormal FBC . You (haematologist, med student, pharmacist, med reg, or other) are asked to offer an opinion on a patient on … Continue reading

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Case 18 – summary

Case Summary – Burkitts lymphoma Our patients initially presented with abdominal pain, which may have had many underlying aetiologies.  With a fairly acute onset there were many diagnoses that needed to be considered.  The key learning points in this case … Continue reading

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Case 18 – update 6

For those with limited morphology experience – how would you describe the findings on the bone marrow? Further testing on bone marrow samples awaited – cytogenetics – which translocation may you find? – cell markers?  what would you expect? Urology … Continue reading

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Case 18 – update 5

Diagnosis??? what do you do next?

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Case 18 – update 4

The patient is taken to HDU for supportive management.  The patient is commenced on treatment for hyperkaleamia.  His fluid balance is carefully monitored.  He is catherised, given analgesia for his abdominal pain.  He requires inotropic support.  An uss abdomen is … Continue reading

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Case 18 – update 3

ITU registrar arrives to review your patient.  He agrees to HDU support and the patient is planned for transfer.  A few further investigations become available. LDH – 4150 ABG pH 7.24, pCO2 2.6, pO2 11.5, HCO3- 14, be -8 Retics … Continue reading

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Case 18 – update 2

Initial blood investigations are back. Hb 84 plt 70 wcc 3.4 Na 136 K 6.5 urea 34.5 creatinine 476 Ca 2.31 albumin 26 ALT 47 ALP 67 Bili 27 Any further blood test needed?  immediate treatment/investigations? Pt is catheterised with … Continue reading

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Case 18 – update 1

Ok, so that was a fairly brief history to work at!  but it has produced some interesting differential – not all haematological which is useful! The patient gives you the following history: He has been generally unwell/lethargic for the past … Continue reading

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Case 18 – the beginning

First case for 2014! A 42 year old gentleman present to accident and emergency with abdominal pain present for the past 24 hours. How would you assess this patient??!!!

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Morphology week – summary

Slide 1 Answer:  Bernard Soulier syndrome, bleeding disorder characterized by thrombocytopenia and large platelets.  Autosomal recessive inheritance.  Presentation consistent with low or dysfunctional platelets and include easy bruising, nosebleeds, mucosal bleeding, menorrhagia, and, occasionally, GI bleeding. Slide 2 Answer:  Hairy cell leukaemia. … Continue reading

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Morphology week – case 2

What would you report on this blood film? Diagnosis?

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Short case blood film – summary

Some great comments from #teamhaem, including: Hairy cells Howell Jolly bodies Ansiocytosis Nucleated red cells Ansiopoikilocytosis Rouleaux All of the above sound good to us.  Some of our followers rightly pointed out that one should not jump to a diagnosis … Continue reading

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Short case blood film – update 1

Below is the blood film from earlier… just higher power.  How would you describe it?  We’ll let you know what that patient had in the end!  Please reply on Twitter and include #teamhaem Please reply on Twitter and always include … Continue reading

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Short case blood film – the beginning

How would you describe this blood film?

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Case 12 – summary

Hairy cell leukaemia   Hairy cell leukaemia is a chronic lymphoid lymphoma of B-cells The hairy cells infiltrate the reticuloendothelial system and interfere with bone marrow function, resulting in bone marrow failure or pancytopenia.  They also infiltrate the spleen and … Continue reading

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Case 12 – update 6

The trephine shows the typical “fried egg cells” seen in hairy cell leukaemia.  The cells appear widely spaced due to abundant cytoplasm, with broad projections.   This is typical hairy cell which may be found on the peripheral blood film – although in … Continue reading

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Case 12 – update 5

Image size increased!!! what would you expect to find on immunohistochemistry? how would you manage this patient?  what are the options?

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Case 12 – update 4

The results you have all been waiting for!!! Can you describe this trephine biopsy?  Start with the basics! Can you make a diagnosis? If so how would you manage this patient?  any more investigations!

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