Hematology Case 17
Hematology Case 17
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Presented By Dr Mohammad Moharram
Released on 2-10-2019Patient Data
Patient Data
52 year old male
Clinical Data
Clinical Data
Previously diagnosed as CML on treatment.
Referred from another hospital with abdominal distention associated with dizziness , constipation and sometimes dysuria.
By examination patient looks ill , his abdomen is rigid and tense. He has huge splenomegally.
Related Laboratory Results
Related Laboratory Results
- WBC: 577x103/uL (Diiferential count see below)
- HGB: 8 g/dL
- MCV: 101 FL
- MCH: 40.5 PG
- MCHC: 41 %
- Platelet: 140 X 103/uL
- INR : 1.6
- LDH: 1723 u/L (R.R.: 98-192) "Increased 3 days after admission to 4113 u/L"
- ALP: 257 u/L (R.R.: 32-91)
- AST : 48 u/L (R.R.: 15-41) "Increased 3 days after admission to 166 u/L"
- Other liver functions , renal functions , amylase , lipase are normal.
Provisional Diagnosis
Provisional Diagnosis
Chronic phase of CML has been progressed to Acceleration phase or Blastic crisis
Case Picture(s) / Photo(s)
Case Picture(s) / Photo(s)
Comment / Findings
Comment / Findings
Marked Leukocytosis:
- Blast Cells: 28%
- Eosinophils : 8.5% with shift to left to level of myelo-eosinophils
- Basophils : 5 %
- Monocytes: 1.5
- Lymophocytes: 1%
- Neutrophils : 56 % with shift to left to level of promyelocytes
Normoblasts are seen : 2 / 100 WBC
Mild thrombocytopnea
Moderate normocytic normochromic anemia (False high indices are due to Marked Leukocytosis interfering with measurement method)
Final Diagnosis
Final Diagnosis
Picture of CML in Blastic Crisis
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