Hematology Case 41
Hematology Case 41
Embedded Files
Presented By Dr Mohammad Moharram
Released on 17-8-2020Patient Data
Patient Data
72 year old male.
Clinical Data
Clinical Data
Patient referred to our hospital due to accidental finding of leukocytosis during investigating his complain of chest pain and shortness of breath.
Generalized lymphadenopathy; left cervical, bilateral axillary and bilateral inguinal lymph nodes are palpable.
No Hepatomegaly or splenomegaly.
No lower limb oedema. Chest and heart auscultation are normal. normal vital data.
CT abdomen : para-aortic and pelvic lymph nodes enlargement.
Related Laboratory Results
Related Laboratory Results
- CBC WBC: 100.6 X 103 /uL - HGB: 12.8 g/dL - MCV: 89.9 fL - MCH: 28.2 pG - MCHC: 31.5% - Platelet: 168 X 103 /uL- Analyzer Differential count (Lymphocytes: 95.1% - Neutrophils: 3.5% - Monocytes: 1.1 - Eosinophils: 0.3%) - Peripheral smear comment → see images and comment below.
- Normal RFT , LFT.
- Normal PT and APTT
Provisional Diagnosis
Provisional Diagnosis
?? Leukemia / Lymphoma
Case Picture(s) / Photo(s)
Peripheral blood smearCase Picture(s) / Photo(s)
Comment / Findings
Comment / Findings
Peripheral blood smear comment:
Marked Leukocytosis. Severe absolute lymphocytosis.
91% of leukocytes are mature looking lymphocytes (Small size, high nuclear cytoplasmic ratio, dense chromatin no visible nucleoli).
Many smudge cells are seen.
4% Atypical lymphocytes.
Picture of lymphoproliferative disorder. (mostly ?? CLL) to be confirmed by immunophenotyping.
Immunophenotyping report
Immunophenotyping report
Immunophenotyping comment
Immunophenotyping comment
The gated lymphocytes constitutes 92% using FSC/SSC gating strategy. They have immunophenotyping pattern consistent with B-chromic lymphocytic leukemia / Small lymphocytic lymphoma.
Final Diagnosis
Final Diagnosis
B-chromic lymphocytic leukemia / Small lymphocytic lymphoma.
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