Question

In: Anatomy and Physiology

Create a mock CBC for the following condition Condition: Multiple myeloma CBC PARAMETER PATIENT RESULTS Precursors...

Create a mock CBC for the following condition

Condition: Multiple myeloma

CBC PARAMETER

PATIENT RESULTS

Precursors

WBC

RBC

HGB

HCT

MCV

MCHC

RDW

MPV

PLAT

Neutrophils %

Lymphs %

Monos %

Eos %

Baso %


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.

Solutions

Expert Solution

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


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