Exam shows cervical lymphadenopathy; you feel firm, round, discrete, mobile nodes. You might feel a spleen and a liver edge too. Routine CBC shows a leukocytosis, mild anemia, and mild thrombocytopenia. Here's the blood smear:
Challenge: What's your diagnosis?First image shown under GNU Free Documentation License; second image shown under fair use.
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2 comments:
cll?
yep!
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Smear
This is chronic lymphocytic leukemia, a chronic lymphoproliferative disorder with accumulation of monoclonal functionally incompetent lymphocytes. The peripheral blood smear shows lymphocytosis of small mature-appearing lymphocytes with a dense nucleus, partially aggregated chromatin, and no discernable nuclei. There is a narrow border of clear to slightly basophilic cytoplasm. The second image shows a smudge cell, lymphocytes that have been flattened in slide preparation, characteristic of CLL.
Sources: UpToDate; Wikipedia; picasaweb.google.com/mcmumbi.
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