Tag Archives: Bone marrow

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

Posted in Myeloma/paraproteins | Tagged , , , , ,

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

Posted in Myeloma/paraproteins | Tagged , , , , ,

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

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

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

Posted in Myeloma/paraproteins | Tagged , , , ,

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

Posted in Anaemia, Bone marrow failure, Laboratory morphology | Tagged , , , , , , | Leave a comment

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

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

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

Posted in Laboratory morphology, Lymphoma | Tagged , | Leave a comment

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

Posted in Lymphoma | Tagged , , , | 2 Comments

Case 18 – update 5

Diagnosis??? what do you do next?

Image | Posted on by | Tagged | Leave a comment

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

Posted in Acute leukaemia, Laboratory morphology, Paediatric haematology | Tagged , , , | Leave a comment

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

Posted in Acute leukaemia, Paediatric haematology | Tagged , | Leave a comment

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

Posted in Chronic leukaemia, Lymphoma | Tagged , , , | 1 Comment

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

Posted in Chronic leukaemia, Laboratory morphology, Lymphoma | Tagged , | Leave a comment

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?

Aside | Posted on by | Tagged , | Leave a comment

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!

Posted in Chronic leukaemia, Laboratory morphology, Lymphoma | Tagged | Leave a comment

Case 12 – update 3

The patient is referred to Haematology and a CT scan is requested.  This confirms splenomegaly with some enlarged mesenteric lymph nodes also identified. A bone marrow biopsy is organised for the following day.  Unfortunately, this is a dry tap and … Continue reading

Posted in Chronic leukaemia, Lymphoma | Tagged , , | Leave a comment

Case 11 – summary

Our patient As with a number of haematological emergencies, the first sign of a major problem is through a grossly abnormal full blood count.  In this case the biomedical scientists made a blood film and confirmed the thrombocytopenia was true. … Continue reading

Posted in Laboratory morphology, Platelet disorders | Tagged , , , | Leave a comment

Case 3 – update 4

The result of your aspirate – what is the diagnosis? What is your management plan?

Image | Posted on by | Tagged , , | Leave a comment