| Case 30 | Hematopathology Case |
| CLINICAL INFORMATION | ||
| 63 year-old male, history of a spontaneous rupture of his spleen approximately one year ago. He denies night sweats, weight loss, fever or lymphadenopathy. Rest of review of systems is negative otherwise. | ||
| CBC WITH DIFFERENTIATION | ||
| BLOOD 11/19 10/22 06/26 03/08 02/09 Reference 2007 2007 2007 2007 2007 07:11 16:02 07:48 14:10 06:45 Units Ranges ------------------------------------------------------------------------------- WBC 13.3 H 13.5 H 13.6 H 12.0 H 14.9 H K/uL 4 to 11 RBC 4.98 4.83 5.20 4.89 5.13 M/uL 4 to 6 HGB 15.3 15.1 16.0 14.1 14.3 g/dL 12.5 to 17 HCT 45.6 44.3 45.2 42.2 43.6 % 37 to 50 MCV 91.6 91.7 86.9 86.3 85.0 fL 80 to 98 MCH 30.7 31.3 30.8 28.8 27.9 pg 27 to 33 MCHC 33.6 34.1 35.4 33.4 32.8 g/dL 32 to 36 RDW 14.1 14.5 14.7 17.7 H 16.9 H % 11.5 to 15 PLT 204 230 282 266 278 K/uL 150 to 450 MPV 12.0 12.0 12.8 H fL 8.3 to 12.4 MPV 11.9 H 13.0 H fL 6.5 to 10 NEUTR % 38.8 L 41.2 L 46.8 42.6 L % 43 to 76 GRAN % % 43 to 76 LYMPH% 47.5 H 46.8 H 38.7 42.9 % 16 to 45 MONO% 9.6 8.5 9.3 10.9 % 5 to 14 EOSIN% 3.6 3.0 4.8 3.4 % 0 to 5 BASO % 0.5 0.5 0.4 0.2 % 0 to 1 NEUTR # 5.2 5.6 6.4 6.3 K/uL 1.7 to 7 GRAN # K/uL 2 to 11.6 LYMPH # 6.3 H 6.3 H 5.3 H 6.4 H K/uL 1 to 3.5 MONO # 1.3 H 1.1 1.3 H 1.6 H K/uL .2 to 1.1 EOSIN # 0.5 H 0.4 0.7 H 0.5 H K/uL 0 to .4 BASO # 0.1 0.1 0.1 0.0 K/uL 0 to .1 | ||
| FLOW CYTOMETRY OF PERIPHERY BLOOD | ||
| Total events analyzed= A gate Bright CD45 positive 50560 events = 14092 (35% of total events analyzed) CD45+/CD14- 99% CD19+/CD3- 4% CD3+/CD19- 86% CD19+/CD20+ 3% CD19+/CD38+ 2% CD19+/CD10+ <2% CD5+/CD19+ <2% CD5+/CD19- 86% CD19+/CD23+ 2% CD19+/FMC7+ 4% CD26+ 19% CD2+/CD7+ 74% CD3+/CD5+ 83% CD3+/CD4+ 49% CD3+/CD8+ 36% CD16+ 12% CD3-/CD56+ 10% Gated on CD19+ cells CD19+/sIg/Kappa+ 59% CD19+/sIg/Lambda+ 42%
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| PERIPHERAL BLOOD SMEAR | ||
| A count of the peripheral blood revealed that 52% of the lymphocytes have a morphology of the following: | ||
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| Wright-Giemsa, 100× | Wright-Giemsa, 100× | |
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| Wright-Giemsa, 100× | Wright-Giemsa, 100× | |
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| Wright-Giemsa, 100× | Wright-Giemsa, 100× | |
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| Wright-Giemsa, 100× | Wright-Giemsa, 100× | |
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| Wright-Giemsa, 100× |
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| Source: Department of Pathology, Creighton University Medical Center, Omaha, NE Photo: Zenggang Pan Discussion: Zenggang Pan | ||