In: Anatomy and Physiology
Create a mock CBC for the following condition
Condition: Multiple myeloma
CBC PARAMETER |
PATIENT RESULTS |
Precursors |
WBC |
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RBC |
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HGB |
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HCT |
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MCV |
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MCHC |
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RDW |
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MPV |
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PLAT |
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Neutrophils % |
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Lymphs % |
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Monos % |
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Eos % |
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Baso % |
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Significant findings that could be present on the differential smear: WBC:
RBC:
PLAT:
Testing to confirm: What are the CD markers and cytogenetic abnormalities? Any relevant cytochemical stains? Other tests?
How is Multiple Myeloma different from Waldenstrom’s macroglobulinemia?
How do Hodgkin’s and non-Hodgkin’s Lymphoma differ?
List the WHO classes of Myelodysplatic syndromes and a few key findings for each.
CBC PARAMETER |
PATIENT RESULTS |
Precursors |
WBC |
3.1 x 103 u/L |
|
RBC |
2.90 x 10 6 u/L |
|
HGB |
10.4 g/dL |
|
HCT |
31.0 |
|
MCV |
106 |
|
MCHC |
33 |
|
RDW |
15.6 |
|
MPV |
8.7 |
|
PLAT |
40,000/cmm |
|
Neutrophils % |
66 |
|
Lymphs % |
16 |
|
Monos % |
14 |
|
Eos % |
3 |
|
Baso % 1 |
2)P smear :
WBC - Plasma cells - eccentric nucleus with cartwheel chromatin pattern, a perinuclear clear area
RBC - Rouleaux formation due to RBC sticking by M proteins
Platelet - thrombocytopenia
3) Multiple myeloma has a osteolytic lesion/fracture, with monoclonal antibodies of IgG, IgA and Light chain.
While walderstrom macroglobulinemia is Hyperviscosity syndrome with neuropathy, bleeding and Hepatosplenomegaly. It has monoclonal antibody of IgM class.
4) Hodgkins lymphoma has contiguous lymph node spread, and has Reed Stenberg cells.
While non Hodgkins lymphoma has non contiguous spread in LN and reed Stenberg celly absent.
5) myelodysplastic syndrome classification
i) RCUD - Refractory cytopenia with unilineage dysplasia
ii) RCMD - Refractory cytopenia with multilineage dysplasia
iii)RARS - Refractory anemia with ring sideroblast
iv) RAEB - refractory anemia with excess of blast