Thursday, January 2, 2014


This FISH analysis comes from a 50 year old radiology technician who presented to his primary care physician with fatigue, weight loss, and abdominal pain. He has splenomegaly on exam but no lymphadenopathy. Laboratory tests show a remarkable leukocytosis with myelocytes and segmented neutrophils. There is also an absolute basophilia and absolute eosinophilia. He also has thrombocytosis and a normochromic, normocytic anemia.

Challenge: What's your diagnosis?

Image shown under GNU Free Documentation License.


Anonymous said...

CML, FISH shows rearrangement of BCR-ABL

webhill said...

is that the Philadelphia chromosome? He has leukemia. And I only know about the Philadelphia chromosome because I read about when I was a kid about a girl with leukemia and they mentioned that chromosome - they didn't bring this up in vet school at any time :). I wish I could remember the name of the book, it's driving me nuts now!

Craig Chen said...

you're right! good memory - i wonder what that book is

This is chronic myeloid leukemia, a myeloproliferative disorder associated with the BCR-ABL t(9;22) fusion gene, also known as the Philadelphia chromosome.

Sources: UpToDate; Wikipedia.