Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2
Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2
48Case 48A 75-year-old male was admitted to the infectious diseases unit on account of confusion, dysuria and fever on a background of progressive nig Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2ght sweats and weight loss. He had a past history of atrial fibrillation, hypertension and type II diabetes melhtus. An initial assessment showed no clinical focus of infection and a CXR was normal. He was treated with broad-spectrum intravenous antibiotics but the fever persisted. Blood and urine c Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2ultures revealed no growth and screening tests for atypical infection were negative.Laboratory dataHb 95g/L. MCV 89 tl, WBC 8.4 X 109/L» neutrophils 5Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2
.8 X 10*/!.. platelets 69 X I0*/L ESR 80 mm/hour.U&Es: Na 128mmol/L. K S.Smmol/L, urea 19mmol/L, creatinine 126 pmol/L.I.FTs and bone profile: bilirub48Case 48A 75-year-old male was admitted to the infectious diseases unit on account of confusion, dysuria and fever on a background of progressive nig Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2protein detected.Serum I.DH: 4340 U/L, CRP 103 mg/L.Coagulation screen: PT 16 s, APTT 33 s, TT 16.9 s, fibrinogen 2.33 g/L, D-dimer 3443 ng/mL.A CT scan of chest, abdomen and pelvis was undertaken because of the possibility of an intra-abdominal abscess or occult tumour but apart from small volume p Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2ara-aortic lymphadenopathy this was unremarkable. MRI of brain showed features of small vessel arterial disease but no evidence of tumour, abscess, suEbook Practical flow cytometry in haematology - 100 worked examples: Part 2
bdural haematoma or venous sinus thrombosis. Ihere were no serological features of a systemic vasculitis and no vegetations were seen on echocardiogra48Case 48A 75-year-old male was admitted to the infectious diseases unit on account of confusion, dysuria and fever on a background of progressive nig Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2equested. There were no new specific clinical findings but the patient remained febrile and confused. Ihe blood film showed no blasts or abnormal lymphoid cells but occasional nucleated red cells and myelocytes were seen. A bone marrow aspirate and a trephine specimen were taken.Bone marrow aspirate Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2The bone marrow aspirate showed a population of very large pleomorphic lymphoid cells with a complex convoluted nucleus and multiple nucleoli (FiguresEbook Practical flow cytometry in haematology - 100 worked examples: Part 2
48.1 -48.3). The cytoplasm was deep blue and some cells showed vacuolation but granules were not seen. The abnormal cells had a diameter two to three48Case 48A 75-year-old male was admitted to the infectious diseases unit on account of confusion, dysuria and fever on a background of progressive nig Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2Flow cytometryFlow cytometry studies were performed and a high blast gate was selected on the FSC/SSC profile in order to characterise the large abnormal cells. Figure 48.4 (Pl). Ibis gating strategy was directed by the morphological review of the aspirate. A standard gating approach could easily ha Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2ve missed the cells of interest.These largest cells were shown to express CD19, CD20 and HI.A-DR. CD10 and surface immunoglobulin were not expressed bEbook Practical flow cytometry in haematology - 100 worked examples: Part 2
ut there was little doubt these cells were clonal and malignant.Practical blow Cytometry in Haematology: 100 Worked Examples, First Edition. Mike Leac48Case 48A 75-year-old male was admitted to the infectious diseases unit on account of confusion, dysuria and fever on a background of progressive nig Ebook Practical flow cytometry in haematology - 100 worked examples: Part 28Case 48169Figure 48.1 MGG.X500Figure 48.3 MGG. xioooFigure 48.2 MGG.xIOOO.HistopathologyI he bone marrow trephine biopsy sections also showed important features. The marrow was hypercellular and clearly involved by the same large cell lymphoid population; these appeared to be primarily located with Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2in the blood vessels and marrow sinuses (arrows, Figures 48.5 and 48.6).By using immunohistochemistry for CD20 this characteristic becomes even more aEbook Practical flow cytometry in haematology - 100 worked examples: Part 2
pparent (Figures 48.7 and 48.8). Here again the extreme size of the lymphoma cells isnoted when compared to the residual normal haemopoietic marrow ce48Case 48A 75-year-old male was admitted to the infectious diseases unit on account of confusion, dysuria and fever on a background of progressive nig Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2ese findings were indicative of an intravascular large B-cell lymphoma (IVL-BCL). In (he interim, the condition of the patient had further deteriorated. He had suffered a fall and showed progressive confusion, bone marrow failure, capillary leak syndrome and170Practical Flow Cytometry in Haematology Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2Figure 48,5 H&E. x500Figure 48.7 CD20. xSOO.Figure 48.6 H&E. x500Figure 48 8 CD2O.X5OOrespiratory failure. Despite the diagnosis his general conditionEbook Practical flow cytometry in haematology - 100 worked examples: Part 2
was such that symptomatic care seemed most appropriate and he died shortly thereafter.Another patient presented to the Neurology department with a fe48Case 48A 75-year-old male was admitted to the infectious diseases unit on account of confusion, dysuria and fever on a background of progressive nig Ebook Practical flow cytometry in haematology - 100 worked examples: Part 2ndrome and a renal biopsy was performed. Ihis showed abnormal hypertrophied glomeruli with interstitial expansion of the mesangium (Figure 48.9). CD20 staining identified a significant intravascular B-cell infiltrate in keeping with IVLBCL (Figure 48.10). Ebook Practical flow cytometry in haematology - 100 worked examples: Part 248Case 48A 75-year-old male was admitted to the infectious diseases unit on account of confusion, dysuria and fever on a background of progressive nigGọi ngay
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