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There were no smudge cells. In light of the edema, hypoalbuminemia, high lipids, and significantly elevated urinary protein excretion, a diagnosis of nephrotic syndrome was made. Cyclin D1 expression is occasionally absent, and in these rare cases, there is usually overexpression of cyclin D2 or D3. Standard forms of chemotherapy are ineffective in patients with TP53 mutations, so ibrutinib or an alternative Bruton tyrosine kinase inhibitor is the treatment of choice. Hematology case studies with answers pdf 2018. On examination, she is ill appearing with a frequent cough and is unable to lie flat. A moderately intensive combination chemotherapy regimen, such as CHOP, is not appropriate because initial therapy in such an indolent disease in which the majority of patients will die with but not because of their T-LGLL.

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An autoantibody screen revealed a positive rheumatoid factor but no other autoantibodies. Mutational screening revealed a mutation of the ID3 gene, a member of the inhibitor of DNA binding gene family, which is frequent in BL and rare in diffuse large B-cell lymphoma (DLBCL). Over the past 2 weeks, visible swelling had developed on the right side of the nose. 5 × 109/L), intermediate neutropenia (0. The blood film confirmed the lymphocytosis, and most of the lymphocytes were of small size without conspicuous nucleoli. A skeletal survey showed diffuse osteoporosis and multiple lytic lesions in the spine, skull, and long bones. 6 mg/dL, total calcium 13. What is the most likely dx? Hematology case studies with answers pdf book. This aching had been present for nearly 1 month. He was treated with six cycles of full-dose rituximab, cyclophosphamide, hydroxydaunorubicin (Adriamycin), vincristine (Oncovin), and prednisone (R-CHOP). Eculizumab: antibody to reduce hemolysis, hemoglobinuria, and need for transfusion.

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What therapy would you advise? A marrow biopsy confirmed that he had classic hairy cell leukemia that was BRAFV600E+. Although MCL is usually an aggressive form of lymphoma, in about 10% to 15% of cases, it follows an indolent course. Urine electrophoresis showed no paraprotein. The normal karyotype makes CML much less likely since it typically manifests with the Philadelphia chromosome t(9;22). Red blood cell transfusion. Serum and urine protein electrophoresis and immunofixation were unremarkable. Seven years earlier, he had presented with an enlarged node in the right side of his neck, and stage II diffuse large B-cell lymphoma (DLBCL) had been diagnosed. Which of the following tests would most likely help confirm the diagnosis? A computerized tomography/positron emission tomography (CT/PET) scan was normal. Hematology and Hemostasis Customer Case Studies and White Papers. Chronic myeloid leukemia (CML). A CT/positron emission tomography scan showed no disease other than that in the pharynx. Which of the following statements regarding treatment outcomes in BL is FALSE? Radiotherapy is necessary in most cases.

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Lytic bone lesions are not seen. He had no relevant previous medical history, and he was on no medications. A 39-year-old woman presented with a slowly enlarging goiter, which produced mild dysphagia without any systemic or gastrointestinal symptoms. Light chain amyloidosis is rare in WM. A diagnosis of Waldenstrom macroglobulinemia (WM) was made.

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The dose of furosemide was halved, and her exercise tolerance improved. What are two viable treatment options? He tells you that he has always been told by his physicians that he has mild anemia; his medical history is otherwise unremarkable. She had moderate asthma and was taking a cysteinyl leukotriene receptor inhibitor. BODY: "gee, you have a 6 Pack & blisters from running").

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He remains well 5 years since diagnosis. He also reports a 6-month history of recurrent headaches and fatigue. Hematology case studies with answers pdf 2017. Her face and conjunctivae are jaundiced, and she has a fading butterfly rash on her face. MBL is rarely found in individuals younger the age of 40 years, but it is progressively more common at ages over that. Shortly after a routine visit, she presented again to her hematologist complaining of headaches and blurring of vision for the previous 24 hours. Polychromasia with numerous microspherocytes. Gamma globulin administration.

Fever and night sweats. Myelodysplastic syndrome (MDS). Which of the following are not correct? Which of the following should you order next? If your patient presents with anemia and elevated reticulocytes, what is the next test you would acquire?

Surgical debridement is not advised except in resistant cases causing continuing distress and with conservative treatment healing occurs in about half. There was generalized lymphadenopathy with the largest nodes measuring 3 cm in diameter. The left ventricular ejection fraction was 47%. Which treatment regimen would you not recommend? The diagnosis was affirmed by the finding of a t(8;14)(q24;q32) within the marrow cell sample, and a gene expression profile (GEP) revealed a typical BL molecular pattern. An excisional biopsy of a cervical lymph node showed nodular sclerosing Hodgkin lymphoma. In addition to intrathecal methotrexate, which of the following would you recommend? She is fit and well 5 years after surgery. Dabigatran is FDA approved only to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. Other sets by this creator. Hematology Case Studies (made up) Flashcards. D. Hypogammaglobulinemia.

The response rate is very high, but deep CRs are not usually achieved. D. A patient previously diagnosed with smouldering myeloma who feels unwell. She remains well, but a recent MRD test of the blood was positive. D. The implant in the other breast must be removed. Her white cell count is 24 × 109/L (65% blasts), hemoglobin is 116 g/L, and platelet count is 130 × 109/L. C) As an ideal resistor in parallel with an ideal capacitor? What treatment do you give your patient with Waldenstrom's macroglobulinemia? Urea and electrolytes, liver function tests, and a calcium and phosphate level were all normal. This patient has a high risk for recurrent venous thrombosis on discontinuing anticoagulation; thus, long-term warfarin is recommended with periodic reassessment for safety. You ordered a UPEP and SPEP test for your patient with suspected Multiple Myeloma. Then bone marrow bx. A cervical node was excised, and histology revealed a diffuse infiltration of small- to intermediate-sized lymphocytes with irregular cleaved nuclei, dense chromatin, and indistinct nucleoli. However, use of a purine analog alone for disease in relapse usually results in a shorter second remission. A mutation in JAK2 was identified by next-generation sequencing.

48-Year-Old Woman With Weight Loss, Hepatomegaly, and Splenomegaly. A complete blood count (CBC) revealed a hemoglobin of 82 g/L with an MCV of 104 fl (reference range, 80–99 fl). He has several risk factors that made him more likely to be diagnosed with AML. B. t(11;18), BIRC3–MALT1 fusion. A 49-year-old man was referred to a hematologist for follow-up from another medical facility. A biopsy of the axillary node revealed grade 1–2 FL positive for CD20 and BCL2. While all of the above regimens are options for advanced stage disease, the choice of therapy should be individualized based on the balance of efficacy and expected toxicity.

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