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