Hematology Case 4
Presented By Dr Mohammad Moharram
Released on 01-05-2019Patient Data
67 year old , Female
Clinical Data
Recurrent sepsis, admitted in surgery ward to prepare for surgical drainage of gluteal abscess.
History of chest infection few weeks ago. Severe Pallor.
Related Laboratory Results
WBC: 20.4x10³/uL
HGB:6.5 g/dL
MCV: 97 fL
MCH: 29.1 pg
MCHC: 30.1%
Platelet: 122x10³/uL
Reticulocytic count: 11.2%
ESR: 140 mm/Hr
BUN: 12.2 mmol/L (R.R.: 2.5-6.4)
Creatinine: 189 umol/L (R.R.: 37-96)
Total Protein: 107g/L (R.R.:65-81)
“Photos attached are peripheral blood smear photos”
Case Picture(s) / Photo(s)
Peripheral Blood Smear
Bone Marrow Aspirate
Comment / Findings
Peripheral Blood smear: show Plasma Cells (24% by differential Count) Few of Them show dysplastic features (lobulated nucleus in page 2 )
Severe Normocytic Normochromic anemia. RBCs show Rouleaux formation.
Bone Marrow Aspirate: Hypercellular Bone marrow with increased plasma cells (40% by differential count)
Final Diagnosis
Picture is suggestive of Plasma Cell Leukemia
Additional Note
Patient is referred to specialized oncology center. Immunophenotyping confirmed the case as Plasma Cell Leukemia.