This week’s case features a patient currently in the Intensive Care Unit (ICU) suffering from acute liver failure. The laboratory data and the resulting blood film provide a sobering look at the systemic impact of hepatic collapse.
This week’s case started with a “heads-up” call from the Haematology SpR before the sample even reached the lab. The staggering WBC and the specific clinical request made for an interesting discussion.
This week’s case began with an urgent call from the haematology Specialist Registrar (SpR) before the sample had even reached the laboratory. A patient had been referred from another hospital and presented to the Emergency Department with a massive clinical picture.
Don’t let a nucleolus default you to “Blast”: Always assess the chromatin density.
62 year old patient presented to ED. Her FBC showed an increased white cell population with the analyser unable to differentiate them properly. The BMS reported them as blasts. Was this correct?
These features are classical for CLL. The combination of a markedly elevated lymphocyte count, characteristic morphology, and a supporting clinical picture strongly points to chronic lymphocytic leukaemia as the final diagnosis.
This week’s case comes from an 84-year-old male who was referred to the haematology team after routine blood tests showed a markedly raised white cell count. Clinically, he reported several weeks of general fatigue but no acute symptoms. He was otherwise well and presented via his GP.
These features are characteristic of May–Hegglin anomaly, one of the MYH9-related disorders. This group of rare inherited conditions presents with thrombocytopenia and large platelets, sometimes accompanied by hearing loss, renal abnormalities, or cataracts.
A 28-year-old female was referred to haematology after routine pre-operative blood tests revealed abnormalities on the full blood count. She reports occasional easy bruising but no significant bleeding history. There’s no recent infection, and she is otherwise well.
The combined clinical, haematological, and immunophenotypic findings are consistent with Chronic Myelomonocytic Leukaemia (CMML).
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