I got the results of NEQAS 2502DM today…
“This film was prepared from the blood of
a 73-year-old man who attended the Emergency Department after experiencing
increasing tiredness, then more recently bleeding from his gums. His white cell
count was found to be elevated, and a blood film was prepared. What is your
opinion of the blood film appearances?”
Bleeding from gums immediately makes me think
“thrombocytopenia” but that isn’t the case. There’s platy of platelets.
Some are clumped and some rather large.
The red cells are on the whole rather dull. There’s a
Howell-Jolly body and a target cell there.
But it’s the white cells that are odd here. Too many of
them, and precious few of them “normal”. There’s smear cells, dysplastic
neutrophils, vacuolated monocytes, and blasty-looking things.
Is this a case of MDS?
I pressed the button before I could comment…
The expert opinion said CLL… seriously?
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