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Tag Archives: splenomegaly
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
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
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
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
Case 75 – the beginning
A 43 year old man presents to A+E with severe back pain. He also has a 2 month history of progressive fatigue. On examination he has pallor, splenomegaly and marked tenderness to L2-L5. How would you further assess this patient? … Continue reading
Posted in Myeloma/paraproteins
Tagged Back pain, fatigue, splenomegaly
Case 52 – summary
Our case was based on a 34 year old lady with a new diagnosis of CML. Diagnosis CML in a proportion of patients is diagnosed on routine blood tests prior to onset of symptoms. However, symptoms can include: lethargy shortness … Continue reading
Posted in Chronic leukaemia, Myeloproliferative neoplasm
Tagged BCRABL, CML, splenomegaly, Thrombocytosis, TKI
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Case 52 – update 2
Great discussion so far regarding staging and options for treatment. Overall I think the consensus is to treat this lady with imatinib. The patient commences treatment and BCR-ABL1 shows a major molecular response at 18 months. At this clinic appointment … Continue reading
Posted in Chronic leukaemia, Myeloproliferative neoplasm
Tagged BCRABL, CML, splenomegaly, Thrombocytosis, TKI
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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 BCRABL, Blood film, CML, morphology, splenomegaly, Thrombocytosis, TKI
Case 52 – the beginning
A 34 year old female presents to A&E with a 2 day history of palpitations. Full blood count shows: Hb 84 g/l (135-180) MCV 91 fl (78-100) MCH 29 pg (27-32) Plts 649 x10*9 (150-400) WCC 88 x10*9 (4-11) Differential … Continue reading
Posted in Chronic leukaemia, Myeloproliferative neoplasm
Tagged BCRABL, CML, splenomegaly, Thrombocytosis, TKI
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
Case 12 – update 1
As the GP, you take a good history from the patient. He is a 48 year old, white british man, previously fit and well. Over the past few months, he has been very lethargic. He has been managing to work fulltime, … Continue reading
Case 12 – the beginning
Working as a GP, you review a 48 year old man. He complains of symptoms of fatigue and abdominal discomfort. On examination you find splenomegaly. How do you proceed? Please reply on Twitter and always include #teamhaem to allow others … Continue reading