Tag Archives: Bone marrow

Case 99 – update 3

A bone marrow biopsy has been carried out: (see below) Aspirate shows erythroid hypoplasia but no dysplastic features. Cellularity is normal and megakaryocyte & granulocyte lineages are normal. For interest, also see Trephine IHC with Glycophorin-C staining – demonstrating reduced … Continue reading

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Case 97 – Summary

This week we looked at a neuropathy presenting via the neurology team associated with a plasma cell dyscrasia. This area of haematology is often challenging! The diagnosis can be difficult and even after diagnosis there is a lack of evidence … Continue reading

Posted in Lymphoma, Myeloma/paraproteins, Related to other specialities | Tagged , , , , , , , , , ,

Case 97 – update 3

Thanks for your help so far with this case. so far we know our patient is a 54 year old male who presented to clinic with distal sensory loss and a broad based gait which has been slowly progressing over … Continue reading

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Case 97 – update 2

The bone marrow aspirate did appear to show an excess of Plasmacytoid and lymphoplasmacytoid cells. Immunophenotype results: Abnormal population: Kappa restricted B cell population = 18% of total nucleated cells. Immunophenotype: CD19+, CD5 negative, CD23 negative/wk, CD10 negative, CD103 negative, … Continue reading

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Case 96 – summary

Thank you for participating in our case this week. This week we have been looking at a case of JMML (Juvenile myelomonocytic leukaemia), which is a rare clonal haematopoietic disorder of childhood, characterised by the proliferation of granulocytic and monocytic … Continue reading

Posted in Bone marrow failure, Myeloproliferative neoplasm, Paediatric haematology | Tagged , , , , , , , , , , , , ,

Case 96 – update 3

The blood film has been reported: – leukocytosis with neutrophilia and monocytosis, there is left shift and toxic granulation and vacuolation. Occasional primitive cells ~ 2%. No nucleated RBCs. The appearances might be reactive/infection related, and infection as well as … Continue reading

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Case 85 – summary

So, our patient has had quite a week! Thanks to your efforts, he is safely back on the ward, conscious and improving.  Recap: We have managed an emergency presentation of an unconscious patient with severe hypercalcaemia, hyperviscosity and an AKI. … Continue reading

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Case 85 – update 2

We rejoin our patient on HDU… He remains unconscious and lacks capacity to currrently make decisions regarding his further management.  Based on our team’s suspicion of an underlying plasma cell disorder, that may be driving our patient’s hypercalcaemia, AKI and … Continue reading

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Case 84 – summary

Thank you for all your help with this weeks case! This week we looked at a case of a patient with type 1 Gaucher’s disease . She was found to be mildly anaemia with a mild thrombocytopenia. A CT scan … Continue reading

Posted in Acquired bleeding, Bone marrow failure, Laboratory morphology, Related to other specialities | Tagged , , , , ,

Case 84 – update 2

So we have the results of our patient’s bone marrow and it looks to be consistent with Gaucher’s disease! Our patient has a raised serum ACE and ferritin which is typical of Gaucher’s disease. Our bone marrow shows the typical … Continue reading

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Case 75 – update 1

Thanks for everyones contributions. The following results are now back:   SFLC kappa: lambda ratio: 6543. Igs and serum electrophoresis: Immuneparesis and IgA kappa paraprotein 18 B2 microglobulin 8.7. Albumin 28. Bone marrow biopsy: 66% plasma cells morphologically. Flow cytometry … Continue reading

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Case 28 – update 2

We had a busy week this week, but have established a diagnosis of Aplastic Anaemia for our young woman. Please see our latest storify if you are interested in our how our discussion evolved (https://storify.com/TeamHaem/case-28) although I will summarise below: … Continue reading

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Case 25 – update 4

In summary you have a gentleman in his 60s with previous splenectomy and high grade diffuse large B cell lymphoma treated with CHOP chemotherapy. He has presented with B symptoms and pancytopenia. He has some interesting travel history. From a … Continue reading

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Morphology – case 4

A staging bone marrow aspirate and trephine biopsy is performed for a 15 year old female with Hodgkin Lymphoma. Automated full blood count shows: Hb 135g/L, PLT 467×10*9/L, WCC 15.1×10*9/L, neutrophils 13.2×10*9/L. No evidence of Hodgkin Lymphoma is seen on … 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 15 – update 5

Bone marrow aspirate confirms your suspicion.  Blast count >60%. Flow cytometry results: CD2 – 12% CD 3-8% CD7 – 12% CD10-86% CD13-2% CD19-60% CD33-1% CD34-71% CD64-2% hla-dr-76% TDT- 47% cd79a- 87% What would these markers suggest? In the UK which … Continue reading

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Case 15 – update 4

As suggested the blood film is suspicious of leukaemia.  You obviously at admit the child for further investigation.  You recognise the risk of tumour lysis. You decide to go ahead and perform a bone marrow under sedation. What other investigations/examinations … Continue reading

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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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