Haematology Lab Studies

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Haematology Lab Studies

• Spring Term

Drs Farmer, Rapson, Shepherd
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Haemoglobin and red cell normal values
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Normal WBC morphology
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Case 1

• Hb 80g/L
• RBC 3.98x1012/L
• MCV 65fl
• RDW 17.5
• WBC 10x109/L
• Platelets 300x109/L
• Retic. Ct 75x109/L

• This 42 year old man had a 2 year history of
  chronic peptic ulcer disease. His routine CBC
  showed..

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Abnormal results
L L L H N

• Hb 80g/L (140-180)
• RBC 3.98x1012/L (4.5-6.5)
• MCV 65fl (80-100)
• RDW 16.5 (11.5-14.5)
• WBC 10x109/L
• Platelets 300x109/L
• Retic. Ct 75x109/L (18-94)

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Case 1
Pencil cell
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Bone Marrow Prussian blue stain for Iron
Absent marrow iron stores
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Case 2

• Hb 100g/L
• RBC 3.47x1012/L
• MCV 79fl
• RDW 14.2
• WBC 9.3x109/L
• Platelets 581x109/L
• Retic. Ct. 55x109/L

• This 36 year old woman had suffered from mildly
  disabling rheumatoid arthritis for 7 years. Her
  CBC showed..

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Abnormal results
L L L N H N

• Hb 100g/L (120-160)
• RBC 3.47x1012/L (4.0-5.5)
• MCV 79fl (80-100)
• RDW 14.2 (11.5-14.5)
• WBC 9.3x109/L
• Platelets 581x109/L
• Retic. Ct. 55x109/L (18-94)

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Case 2
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Case 2 Bone Marrow Prussian blue stain for iron
Iron stores increased 4/4
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Case 3
This 63 year old woman complained of malaise,
cough with greenish sputum, and intermittent
chest pain for one week before admission to
hospital. On admission, her temperature was 39.5C
and her CBC data was...

• Differential
• Neutrophils 10.55x109/l
• Lymphs 0.18x109/L
• Monocytes 0.18x109/L
• Eosinophils 0.35x109/L
• Basophils 0.1x109/L
• Bands 4.57/109/L
• Metamyelo 1.58/109/L
• Myelocytes 0.18x109/L

• Hb 125g/L
• WBC 17.6x109/L
• Platelets 267x109/L

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Case 3
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Dohle body
Left shift. Toxic changes.
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Case 4

• This 46 year old man had prematurely grey hair
  and complained of a sallow, slightly yellow
  complexion for 3 years. His CBC showed.

• Hb 76g/L (140-180)
• RBC 3.86x1012/L (4.5-6.5)
• MCV 115fl (80-100)
• RDW 18.0 (11.5-14.5)
• WBC 3.2x109/L
• Platelets 110x109/L
• Retic. Ct. 25x109/L (18-94)

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Abnormal results
L L H H L L L

• Hb 76g/L (140-180)
• RBC 3.86x1012/L (4.5-6.5)
• MCV 115fl (80-100)
• RDW 18.0 (11.5-14.5)
• WBC 3.2x109/L
• Platelets 110x109/L
• Retic. Ct. 25x109/L (18-94)

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Case 4
megaloblast
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Case 4
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Case 4 Bone Marrow
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Case 5

• Hb 100g/L
• RBC 3.86x1012/L
• MCV 79fl
• RDW 26.0
• WBC 5.7x109/L
• Platelets 16x109/L
• Retic. Ct. 180x109/L

• This 26 year old woman was seen in the Emergency
  Room with complaints of fever, slurred speech and
  severe headache. Her CBC showed...

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Abnormal results
L L L H L H

• Hb 100g/L (120-140)
• RBC 3.86x1012/L (4.0-5.5)
• MCV 79fl (80-100)
• RDW 26.0 (11.5-14.5)
• WBC 5.7x109/L
• Platelets 16x109/L (150-450)
• Retic. Ct. 180x109/L (18-94)

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Case 5
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TTP fibrinous stenosis of small blood vessel
Red cell damage
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Case 6
This 68 year old man complained of left-sided
abdominal fullness and intermittent left
shoulder pain for 3 months. His CBC was...

• Differential
• Neutrophils 64.9x109/L
• Lymphs 13.4x109/L
• Monocytes 2.4x109/l
• Eosinophils 2.4x109/L
• Basophils 7.3x109/L
• Bands 3.0x109/L
• Myelocytes 3.6x109/L
• Metamyelocytes 14.6x109/L
• Blasts 6.1x109/L
• NRBC 6.1x109/L

• Hb 105g/L
• WBC 128.1x109/L
• Platelets 610x109/L

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Case 6
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Basophilia
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CML High Power
myelocyte
blast
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Massive splenomegaly in CML
infarct
30cm
The cause of abdominal fullness and shoulder tip
discomfort
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Case 7
This 42 year old woman presented with fatigue and
bruising

• Differential
• Neutrophils 0.8x109/L
• Lymphs 2.0x109/L
• Monocytes 0.4x109/l
• Eosinophils 0.2x109/L
• Myelocytes 0.6x109/L
• Blasts 1.0x109/L

• Hb 105g/L
• WBC 5x109/L
• Platelets 55x109/L

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Case 7
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Case 7 Bone Marrow
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Bone marrow biopsypacked
Bone trabeculae
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Case 8
A 3 year old boy presented to the Emergency Room
with bruising. His CBC showed ..

• Differential
• Neutrophils 0.3x109/L
• Lymphs 2.7x109/L
• Monocytes 0.7x109/l
• Eosinophil 0.2x109/L
• Basophils 0.1x109/L
• Bands 0.0x109/L
• Blasts 9.0x109/L

• Hb 33g/L
• WBC 13.0x109/L
• Platelets 37.0x109/L

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Case 8
nucleolus
Blast cells
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Bone Marrow
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Bone Marrow..packed with blast cells
Acute leukemia
Immunophenotyping confirms acute
B lymphoblastic leukemia
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Case 9
This 58 year old man sought help because of small
non-tender lumps in his neck, axillae, and
inguinal areas which had been present for several
months. His CBC showed

• Hb 92g/L
• WBC 22.0x109/L
• Platelets 150.0x109/L
• RBC 3.2x1012/L
• RDW 15.8
• Retic. Ct 200x109/L

• Differential
• Neutrophils 2.5x109/L
• Lymphs 19.2x109/L
• Monocytes 0.2x109/L
• Eosinophils 0.1x109/L
• Basophils 0.0x109/L
• Comment Occasional smudge cells present

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Case 9
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Case 10
This 23 year old man had complained for one week
of severe sore throat, malaise, and lethargy.
His CBC was...

• Differential
• Neutrophils 1.5x109/L
• Lymphs 13.3x109/L
• Monocytes 0.8x109/L
• Eosinophils 0.4x109/l
• Basophils 0.0x109/L
• Comment moderate atypical lymphs

• Hb 158 g/L
• WBC 16.0x109/L
• Platelets 150x109/L

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Case 10
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Case 10
Atypical lymphocytes
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Infectious MononucleosisEB Virus

• Infects B-lymphocytes
• Generalized T-cell reaction
• Monospot test
• (Quick test for mono)
• EBV serology