Pathology Notes

Practice questions answers Lymphoid neoplasms III © Jun Wang, MD, PhD   1. C. This case is characterized by acute onset anemia, marked leukocytosis and thrombocytopenia. Peripheral blood smear reveals immature cells with scant agranular cytoplasm and large nuclei with fine chromatin. These are highly suggestive of the presence of blast and acute leukemia. Flow-cytometry may identify the type and number of these blasts in order to diagnose acute myeloid leukemia , or acute lymphoblastic leukemia . Blood culture is used for bacterial infection involving blood stream, such as sepsis . Bone marrow biopsy can be used in diagnosing marrow associated disorders, such as anemia and hematopoietic neoplasms, especially myeloid neoplasms . However, flow cytometry can accurately measure the level of blasts in either marrow or blood. Hemoglobin electrophoresis is used to diagnosing hemoglobin abnormalities . Lymph node biopsy may be used to diagnose a localized disorder involving a lymph no

Practice questions Lymphoid neoplasms III © Jun Wang, MD, PhD   1. Use this case and image for the next three questions. A 12-year-old boy presents to the clinic with persistent fatigue, easy bruising, and occasional nosebleeds for the past 2 weeks. He has progressive fatigue for a month. His past medical history is unremarkable. His vital signs are within normal range. Physical examination reveals pale skin and conjunctiva without jaundice. Numerous petechiae are seen on his extremities. A few cervical lymph nodes are palpated. His CBC reveals a hemoglobin of 8.5 g/dL (11.5-12.8 g/dL), WBC count of 54 x 10 9 /L (4.5-10 x 10 9 /L), platelet count of 75 x 10 9 /L (160-320 x 10 9 /L). An image of his peripheral blood smear is shown. What test should be performed next for diagnosis? (Image credit: James Grellier - derivative of original work by VashiDonsk at en.wikipedia, CC BY-SA 3.0 <https://creativecommons.org/licenses/by-sa/3.0>, via Wikimedia Commons) A. Blood cult