Case 16 Please answer questions. The presenting symptoms of a 56-year-old man in
ID: 3517590 • Letter: C
Question
Case 16
Please answer questions.
The presenting symptoms of a 56-year-old man include a skin rash and dermatitis.
Manual differential counts:
WBC: 28.3 Band neutrophils:
RBC: 3.80 Segmented neutrophils: 21
Hgb: 12.0 Lymphocytes: 19
Hct: 36.1 Monocytes: 10
MCV: 95.0 Eosinophils: 1
MCH: 31.5 Basophils:
MCHC: 33.2 Metamyelocytes:
RDW: 13.9 Myelocytes:
PLT: 160.9 Promyelocytes:
Abnormal mononuclear cells with cerebriform ? clefted nuclei: 49
1. Describe the peripheral blood findings.
2. What additional tests should be performed?
The results of the proposed additional tests were as follows:
Skin biopsy: atypical lymphocytes with convoluted nuclei that are positive for CD2, CD3, and CD4 and negative for CD7
3. Based on all the data provided, what condition is most likely?
4. What is the most likely status of the bone marrow?
5. What information is most diagnostic?
Explanation / Answer
1. peripheral blood finding:the peripheral blood smear, is used to detec abnormalities in blood smear, the 3 main blood cells in this is red blood cells, white blood cells, platelets, there in this patient the red blood cells value and lymphocyte value and neutrophils are less than normal so it indicates there is an abnormality in the patient. 2.the additional test performed for this patient are patch test and skin biopsy. 3. the condition is adult T cell leukaemia/ lymphoma. 4. The bone marrow, there is increased vascularity and a patchy polymorphic infiltrate comprising aggregates of small medium lymphoid cells. 5.the skin biopsy is most diagnostic.
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