Hematology Case 28

Presented By Dr Ghada Balah

Released on 28-03-2020

Patient Data

18 YEARS OLD MALE

Clinical Data

A case of colonic lymphoma on chemotherapy , asymptomatic chest "clear", no lower limb oedema.

Presented with fever and cough

On Examination; tachycardia 140 , Blood Pressure 116/70, Resp. Rate 25 , chest clear, abdomin soft & lax .

Hard swelling (15cmby15cm) extending from Rt iliac fossa to the suprapubic area, patient presented with abdominal pain , lower abdominal swelling / 20 days, bleeding per rectum three times ? Impdeing intestinal obstruction ?

Pleural effusion aspiration from right side; for cytology cell count "See Pictures"

Related Laboratory Results

GRAM STAIN No Bacteria Seen

AFB STAIN AFB - NEGATIVE

ALT(SGPT) 41.90 HIGH ABNORMAL U/L [0-41]

Normal RFT

  • HEAMOTLOGY (Pleural Fluid Cytology):

Total Cell Coun: 4 x10^3/uL,

Polymorph. cells: 15%,

Mononuclear cells: 65%,

Abnormal MonoNuclear Cells : 20% (See photos)

Case Picture(s) / Photo(s)

Comment / Findings

20% Abnormal Mononuclear Cells with blastoid features (medium to small size cells , high N/C ratio, fine nuclear chromatin) cytological examination and flowcytometry are recommended.

Final Diagnosis

Pleural fluid secondaries by lymphoma cells.

It is recommended to be tested by immunophenotyping to confirm its relation to the primary lesion.