A while back I performed NEQAS digital morphology case 1605 DM:
Your CPD report has been submitted
Your observations:
Lymphocytosis 1
Tear drop poikilocytes 2
Smear/smudge cells 3
Thrombocytopenia 4
Anisochromia 5
What would you suggest is the most appropriate white cell comment?
Appearances suggest CLL
What do you think is the most likely cause for the anaemia?
If it was iron deficiency I'd expect pencil cells Tear drop cells hint at myelofibrosis
In my notes I actually said "CLL but what is with the red cells". It *was* CLL and the case notes said "blah, blah...The actual cause of the anaemia was a beta thalassaemia trait. This diagnosis was not a challenge in our laboratory since (unusually) all the diagnostic information was given on the request form so we will never know if we would have correctly identified the cause in this challenging case!"
Interesting... Bearing in mind CLL is a condition of the elderly I wouldn't expect thalassaemia to be a chance finding in someone of that age... I think I did OK...
No comments:
Post a Comment