Case study help. What might they have? a). 10-year-old female. complaints of let
ID: 50789 • Letter: C
Question
Case study help. What might they have?
a). 10-year-old female. complaints of lethargy and leg pain. Splenomegaly and lymphadenopathy present in physical exam. WBC: 6.5 × 10^9/L; Hb: 8 g/dL; Platelet: 21× 10^9/L
Peripheral blood smear revealed – Predominance of very young blood cells (blasts)
• These cells are normally found only in the BM
BM examination
100% cellularity (red marrow)
Predominance of the same type of blasts that were seen in the peripheral blood
Question 1: Describe Francine's BM as normal, hyerplastic, or hypoplastic.
Question 2: What condition can cause this bone marrow finding?
Question 3: What do you think is the cause of the splenomegaly?
Question 4: Why might the peripheral blood reveal changes associated with hyposplenism when
the spleen is enlarged?
Question 5: What might explain the lymphadenopathy?
I am assuming she has leukemia of the lymphocytic cells, but I need help understanding these questions please.
Explanation / Answer
1. Hyperplastic since it contains red marrow which indicates the presence of red blood cells.
2.Anemia can cause the over production of red blood cells in the bone marrow.
3. Spleenomegaly in this case is caused by the accumulation of the blast cells in the spleen.
4. The peripheral blood smear indicates the presence of blast cells. Normal cells are broken down in the spleen. IF the RBC were normal, the cause of splenomegaly would be different. Since the cells are blast cells, they accumulate in the spleen leading to spleenomegaly.
5. The lymphadenopathy is also due to the same reason as splenomegaly. Accumulation of the blast cells.
The diagnosis is Acute Myelogenous Leukemia.