Tag Archives: Blood film

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

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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

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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 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

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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

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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 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

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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

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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

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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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Case 86 – part A2

This short case focused on the diagnosis of thalassaemia over iron deficiency. The below factors can help, but there are many overlapping factors and this is more of a guide rather than absolute. Factors that may make this unreliable include … Continue reading

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Case 86 – part A1

Welcome to #TeamHaem. This week we are going to look at some blood film morphology. A 21 year old female student has a full blood count done due to fatigue. Hb 100g/L MCV 74fl MCH 21.7pg Platelets 250×109/l WCC and … 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 78 – the Beginning

A 72 year old lady has attended pre- assessment clinic for an elective hip replacement and had routine bloods taken. Blood results: Hb 93, MCV 97, Plt 220, Wcc 7.5,  Neu 0.9, lymph 6.0. Normal Liver and Renal function  Blood … Continue reading

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Case 77 – summary

Case 77 Summary   Thanks to everyone who contributed to the case this week.   Our case started with a blood film to test our morphology skills.  We picked up that the blood film showed: Dysplastic neutrophils Blasts NRBCs Tear … Continue reading

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Case 77 – update 2

Bone marrow results: 13% blasts evidence of dysplasia in the erythroid and myeloid cell lines Cytogenetics:trisomy 8   How would you classify this patient? What would be your approach to management?

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