Page 461 - Clinical Hematology_ Theory _ Procedures ( PDFDrive )

CHAPTER 22 ■ Lymphoid and Plasma Cell Neoplasms 445

CASE STUDIES (continued)
CASE STUDIES (continued)

■ Follow-Up 2. Fro wh t type o bnor lity is the p tient su ering?
RAP st in w s neg tive.

3. Wh t other l bor tory ss ys woul i in est blishing

■ Critical Thinking Group Discussion Questions i gnosis o this n’s con ition?
1. Wh t is this p tient’s i gnosis?

Case Study 22.6

2. Wh t ollow-up tests re nee e to conf r i gnosis? An 80-ye r-ol n, n tive o the Do inic n Republic,

w s tr ns erre ro rur l co unity hospit l to
3. Is this cl ssic ex ple o ly phoproli er tive Boston e ching Hospit l bec use o ultiorg n ilure.

isor er? At ission, he w s we k n leth rgic. He exhibite

severe ly ph enop thy.
Case Study 22.5

A 60-ye r-ol n sought e ic l vice er su - ■ Laboratory Data

ering ro tigue, upper b o in l p in, n 20-lb He oglobin 8.2 g/ L

weight loss over the p st 9 onths. Physic l ex in tion He tocrit 22%

reve le isten e b o en with ssive spleno eg ly ot l RBC count 3.0 × 10 /L
12
n o er te hep to eg ly. T ere w s no evi ence o ot l WBC count 14.0 × 10 /L
9
ly ph enop thy.
Peripher l bloo s e r ex in tion reve le ny ly -

■ Laboratory Data phocytes (62%) n ny v ri nt ly phocytes with pro i-
He oglobin 10.0 g/ L nent nucle r lob tion s well s ew nucle te RBCs. T e

He tocrit 33% nu ber o pl telets w s slightly ecre se . T e erythrocytes
ot l RBC count 4.0 × 10 /L were icrocytic n hypochro ic.
12

ot l WBC count 120.0 × 10 /L
9
ot l pl telet count 153 × 10 /L ot l bilirubin 5.3 g/ L (re erence r nge, less th n
9
1.5 g/ L)

■ Erythrocyte Indices
MCV 90 L ■ Critical Thinking Group Discussion Questions

MCH 25 pq 1. Fro wh t type o bnor lities is he su ering?

MCHC 33 g/ L

2. Wh t coul be the c use o his bnor l f n ings?
■ Peripheral Blood Smear Examination

Mononucle r cells 65%.
Seg ente neutrophils 5%. 3. Wh t steps ust be t ken to est blish i gnosis?

Ly phocytes (proly phocytes) 30%.
Decre se pl telets were note .

NOTE: This is a good time to write out the answers to the
■ Critical Thinking Group Discussion Questions
1. Wh t is the ost bnor l l bor tory f n ing? Critical Thinking Group Discussion Questions.

REVIEW QUESTIONS

*Indicates ML (optional) and MLS advanced content. 2. T e e i n surviv l ti e o p tients with CLL, co -

1. Te ost co on or o chronic leuke i in Western p re with p tients with chronic onocytic leuke i , is
countries is A. not signif c ntly i erent

A. yelogenous B. shorter
B. ly phocytic C. longer

C. onocytic D. shorter, i the p tient is e le
D. eosinophilic

(continued)