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Which of the following tests would most likely help confirm the diagnosis? The chronicity of MDS—in particular, anemia preceding the diagnosis of pancytopenia by several years—is in contrast to the typically acute manifestation of AML, which is therefore an unlikely possibility in this patient. Splenomegaly and hepatomegaly occur in about 80% of cases of μHCD. Which of the following statements regarding treatment outcomes in BL is FALSE? B. Hematology and Hemostasis Customer Case Studies and White Papers. t(11;14)(q13;q23). 32-Year-Old Female with Multiple Ecchymoses.

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Biopsies confirmed persistence of EMZL. They also have ulcerative colitis. According to the NCCN guidelines, biopsy of a suspicious site, dermatopathology review of the slides, use of an extensive immunohistochemistry (IHC) panel (CD2, CD3, CD4, CD5, CD7, CD8, CD20, CD30), and molecular analysis to detect clonal T-cell antigen receptor gene rearrangements are required for diagnosis. The creatinine was raised, and the estimated creatinine clearance was 29 mL/min. Increased mast cells were seen in association with the lymphoid aggregates. Clinical Hematology Theory and Procedures, 6th ed, Jones and Bartlett Learning, 2017. Chronic myeloid leukemia (CML). Hematology case studies with answers pdf download. There were increased left ventricular (LV) wall thickness, reduced LV systolic function, shortened deceleration time, and increased ratio of early diastolic filling velocity to atrial filling. Myeloid growth factors: G-CSF or GM-CSF.

She returned to see her doctor 3 months later, by which time the lethargy had increased, and the ankle edema had become more pronounced. This is based on a hemoglobin below 120 g/L, stage 3 and age older than 60 years. Similar considerations apply to the use of allografts. E. The WM clone often expresses CD25.

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During the evaluation, an electrocardiogram showed low-voltage QRS complexes in the limb leads. An autopsy revealed extensive infiltration of the liver, spleen, lymph nodes, marrow, and kidney by abnormal lymphocytes. C. Outcomes remain favorable for adults aged 40–70 years old in the United States, with 5-year survival rates well in excess of 60%. Curative radiation could also be discussed because recent data showed long-term progression-free survival (PFS) for localized FL treated with radiation alone. His blood flow cytometry showed a monoclonal population of cells positive for CD20, CD11c, CD25, and CD103. Hematology Case Studies (made up) Flashcards. Answer c. This patient has multiple myeloma with evidence of end-organ damage from the plasma cell proliferative disorder (hypercalcemia, renal failure, anemia, and osteolytic bone lesions).

Test= Smear (looking for rouleaux cells). A diagnosis of amyloidosis was confirmed, and microdissection mass spectroscopy showed that the amyloid was composed of Ig light chains. She has had chronic fatigue and anemia. C. Radioimmunotherapy. The bilirubin was raised at 42 μmol/L with only 10% conjugated. Both are clinically similar indolent diseases associated with immune neutropenia and anemia.

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Marrow and disseminated nodal involvement occurs in fewer than 20% of cases. Some patients with light chain amyloidosis have typical myeloma signs or symptoms such as hypercalcemia, renal failure, anemia, and bone lesions (CRAB criteria), but if these are not present when the amyloidosis is diagnosed, they do not usually develop. Electrolyte levels were normal, and the estimated creatinine clearance was 45 mL/min. Mature T-Cell and Natural Killer Cell Lymphomas Case 3. 12-Year-Old Boy With Normocytic Anemia and Bone Pain (August 2011). Importantly, there was also more toxicity in the brentuximab + AVD arm, including a higher incidence of peripheral neuropathy and neutropenia mandating growth factor support. Case studies in hematology and coagulation. The patient had a CT/PET scan, and no disease was found outside of the breast. Which treatment regimen would you not recommend? GEP was not performed. Dimorphic erythrocyte population with pronounced macrocytes.

Rituximab is an anti-CD20 monoclonal antibody that improves overall survival when added to CHOP chemotherapy for aggressive B-cell lymphomas. D. Serial determinations of soluble IL-2 receptor can be used to follow the course of the disease. The MCV was 73 fL (reference range, 80–98 fL), and the blood film showed hypochromia and poikilocytosis. In July, 20 days after the bone marrow procedure and AML diagnosis, the patient was scheduled to begin his first cycle of Azacitidine (Vidaza). Which of the following is not usually seen in μHCD? Dabigatran is FDA approved as an anticoagulant for patients who have received a mechanical heart valve. Hematology case studies with answers pdf.fr. Should this patient receive immediate therapy? The PET scan at diagnosis is also shown (Fig. When a patient presents with premature gallstones, one should consider whether they may be due to pigment gallstones from chronic hemolysis causing indirect hyperbilirubinemia. The choice of which antibiotics to use should be based on local resistance patterns. Find (a) the stopping potential for the same target under 260-nm radiation.

A marrow aspirate and biopsy revealed infiltration of approximately 40% by κ light chain–restricted plasma cells. CBC: low Hg and low Hct. Her conjunctivae are pale, and she has active synovitis affecting both knees, her wrists, and elbows, with rheumatoid nodules on the extensor surface of her right forearm. 48-Year-Old Woman With Weight Loss, Hepatomegaly, and Splenomegaly. At this visit, she complained of vague abdominal fullness. Think: I'll buy sausage and walnuts with my stack of coins). What therapies would generally be considered to be inappropriate? Liposomal vincristine is approved for third line treatment of ALL; neurotoxicity is its major adverse effect. There was also a suggestion of irregular thickening of the capsule surrounding the implant, so she was referred to a surgical oncologist. Infiltration of the gut, often in the form of polyposis coli, is present in up to 60% of cases if a colonoscopy is performed, with symptomatic bowel disease being present in about 25%. Other findings on physical examination are normal. Subsequently, the neutrophil count dropped over a period of about 6 months to 0.

Patients are often maintained on prophylaxis for herpes zoster reactivation for months after completion of antileukemic therapy. D. Six cycles of brentuximab vedotin + AVD. About 50% of patients are cured by involved field radiotherapy, and nearly all the rest progress to myeloma. He was diagnosed with non-small-cell lung cancer (NSCLC) 6 years ago. There is frequent expression of the follicular T helper markers such as ICOS and CXCL13. Flow cytometry of the peripheral blood lymphocytes shows a monoclonal B population with dim expression of λ light chain and CD20 that is positive for expression of CD5, CD19, and CD23. Light chain–related amyloidosis. Special coagulation testing confirms the persistence of an LAC. Clinical Reasoning Cases in Nursing. His lungs have scattered inspiratory crackles in the right midlung field.

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