This week we have a case from a 61-year-old patient who presented with persistent fatigue and unintentional weight loss. Routine bloods were performed, and the full blood count has raised some important red flags.
Full blood count results:
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WBC: 50.4 × 10⁹/L
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RBC: 2.96 × 10¹²/L
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Hb: 84 g/L
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HCT: 0.245
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MCV: 91.5 fL
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MCH: 28.4 pg
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MCHC: 339 g/L
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RDW: 15.2%
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Platelets: 122 × 10⁹/L
The analyser also generated abnormal scattergram flags and a blast flag, prompting a manual differential and film review.
The sample was sent for flow cytometry. Here is a summary of the immunophenotype results:
| Marker | Expression |
|---|---|
| CD45 | Dim–moderate |
| CD34 | Negative |
| CD117 | Variable weak |
| HLA-DR | Positive |
| CD13 | Positive |
| CD33 | Strongly Positive |
| CD14 | Positive in a subset |
| CD64 | Stronly Positive |
| CD36 | Positive |
| CD11b | Positive |
| CD15 | Variable |
| CD16 | Negative |
| CD56 | Negative |
| CD7 | Negative |
| CD19 | Negative |
There’s quite a lot going on here. What stands out to you at first glance? Drop your initial thoughts below.
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