Tag Archives: Blood film

Case 77 – update 1

So far, we have a 54 year old male who is pancytopenic.  He demonstrates features of myelodysplasia on blood film. we have not had any clinical details, but most have suggested admission which does not seem unreasonable given the patients … Continue reading

Posted in Acute leukaemia, Bone marrow failure | Tagged , , , ,

Case 77 – the beginning

  Let’s start this case with a blood film. Can you describe the findings on the film? What information would you like as the registrar reviewing the film?   Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem … Continue reading

Posted in Acute leukaemia, Bone marrow failure, Laboratory morphology | Tagged ,

Case 69 – part 2 – summary

This patient has a medical emergency. She has pancytopenia with evidence of bleeding. There are abnormal promyelocytes and faggot cells (below) which are indicative of acute promyelocytic leukaemia. Acute promyelocytic leukaemia is a subtype of acute myeloid leukaemia characterised by … Continue reading

Posted in Acquired bleeding, Acute leukaemia | Tagged , , , , , , ,

Case 69 – part 2 – the beginning

A 21 year old female presents with epistaxis and bleeding gums and the following blood count: Hb 69g/L Platelets 27×10*9/L WCC 12×10*9/L     Questions What is your immediate management? What tests would you like to perform?   Please reply … Continue reading

Posted in Acquired bleeding, Acute leukaemia | Tagged , , , , , , ,

Case 69 -part 1 – summary

The blood film was leucoerythroblastic with left shifted granulocytes and nucleated red cells. There were tear drop cells with red cell anisopoikilocytosis and enlarged platelets.    A leucoerythroblastic film can be seen in the following: Marrow infiltration (haematopoietic and non-haematopoietic malignancy, … Continue reading

Posted in Myeloproliferative neoplasm, Related to other specialities | Tagged , , , , ,

Case 69 – part 1 – the beginning

A 58 year old gentleman presents with fatigue and weight loss. As part of the work up he has a full blood count performed and a blood film is made:     Questions How name five features on the blood film? … Continue reading

Posted in Myeloproliferative neoplasm, Related to other specialities | Tagged , , , , ,

Case 63 – summary

Thanks to everyone who has taken part in this week’s case. It focused on childhood anaemia and it’s investigations. See a link to our Storify of this week’s case https://storify.com/TeamHaem/case-63-a-pale-child   Childhood anaemia There are a number of causes of anaemia … Continue reading

Posted in Anaemia, Paediatric haematology | Tagged , , , , , , , , , , ,

Case 63 – update 4

Our four year old appears to have acute parvovirus infection. It commonly causes reduced rd cell production but this is generally only significant in patients with increased red cell destruction, who rely on a very active marrow e.g. inherited and … Continue reading

Posted in Anaemia, Paediatric haematology | Tagged , , , , , , , , , , ,

Case 63 – update 3

Our four year old has spherocytes on the blood film. These are seen in various types of haemolytic anaemias – mainly autoimmune haemolysis and hereditary spherocytosis. There is a lack of polychromasia reflecting the lack of marrow turnover and linking … Continue reading

Posted in Anaemia, Paediatric haematology | Tagged , , , , , , , ,

Case 63 – update 2

Our four year old has been having fever and is pale. A blood count showed: Hb 45g/l (115-145g/l) MCV 85fL WCC 12×10*9/l (5-15×10*9/l) with normal white cell differential Platelets 352×10*9/l (150-450×10*9/L) Reticulocytes 5×10*9/l (50-100×10*9/l)   A blood film is requested and … Continue reading

Posted in Anaemia, Paediatric haematology | Tagged , , , , , , , ,

Case 52 – update 1

This patient gives a history of palpitations for the past two days.  On questioning she has noted occasional night sweats, and describes some abdominal fullness, but otherwise is usually fit and well with no significant past medical history.  She is … Continue reading

Posted in Chronic leukaemia, Myeloproliferative neoplasm | Tagged , , , , , ,

Case 50 part 5 – summary

This case was an interesting one! As haematologists we have a privileged position of being able to get to know our patients extremely well and also have the skills to review their marrow under the microscope in order to reach … Continue reading

Posted in Laboratory morphology, Related to other specialities | Tagged , , , , | Leave a comment

Case 50 part 5 – update

You have a 41 year old female with night sweats, splenomegaly and pancytopenia.   Differential diagnosis from #teamhaem are: Lymphoma e.g. splenic marginal zone lymphoma or hairy cell leukaemia or even a high grade lymphoma Myeloproliferative neoplasm e.g. myelofibrosis Metastatic … Continue reading

Posted in Laboratory morphology, Related to other specialities | Tagged , , , , | Leave a comment

Case 50 part 5 – the beginning

You are the haematologist in a busy clinic. You are referred a patient with splenomegaly and pancytopenia. She has been suffering from night sweats. A full blood count shows: Hb 92g/L (115-160) MCV 89fL (79-98) WCC 2.5×10*9/L (4-11) Neuts 1.0×10*9/L … Continue reading

Posted in Laboratory morphology, Related to other specialities | Tagged , , , , | Leave a comment

Case 50 part 4 – summary

The laboratory data of anaemia, thrombocytosis, a leucoerythroblastic film and tear drop poikilocytes point towards a diagnosis of myelofibrosis. Other causes of a leucoerythroblastic film with tear drop poikilocytes may include: Beta thal intermedia/major (this should be obvious from the … Continue reading

Posted in Laboratory morphology, Myeloproliferative neoplasm | Tagged , , | Leave a comment

Case 50 part 4 – update

#TeamHaem correctly identified the main abnormalities in the film: Tear drop poikilocytes Leucoerythroblastic features (left shifted granulocytes and nucleated red cells) The patient had splenomegaly and was suffering from weight loss and subjective fevers.   Questions: Name three possible causes of … Continue reading

Posted in Laboratory morphology, Myeloproliferative neoplasm | Tagged , , | 2 Comments

Case 50 part 4 – the beginning

You are the GP reviewing a patient. He has indigestion and looks pale. A FBC is done: Hb 92g/L (115-160) MCV 76fL (79-98) WCC 15.6×10*9/L (4-11) Neuts 12.6×10*9/L (2-7) PLT 578×10*9/L (150-400) Here is the blood film:   Questions: Describe … Continue reading

Posted in Laboratory morphology, Myeloproliferative neoplasm | Tagged , , | Leave a comment

Case 50 part 3 – summary

It just goes to show that picking up on simple signs can lead to the start of a diagnostic journey. The patient with the film below (second from left) had a FBC as she had suffered from back pain and … Continue reading

Posted in Laboratory morphology, Myeloma/paraproteins | Tagged , , | Leave a comment

Case 50 part 3 – the beginning

You are reviewing the blood films from today. Can you make a diagnosis without a microscope?     Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please join in the … Continue reading

Posted in Laboratory morphology, Myeloma/paraproteins | Tagged , , | Leave a comment

Case 50 part 2 – summary

In haematology it is important integrate laboratory investigations to clinical presentations. A blood transfusion was requested in a young patient with macrocytic anaemia with no previous blood count information. The blood film was reviewed rapidly:   The diagnosis of a … Continue reading

Posted in Anaemia, Haemoglobinopathy, Laboratory morphology, Transfusion | Tagged , , , | Leave a comment