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General
and Systemic Histopathology, C601&C602
Virtual Slide: A 5 year-old girl comes for a
pre-school physical exam.
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This
5 year-old girl comes for a pre-school physical exam. Her mothe r indicates she
has been listless, complains of headaches, arm and leg pains. Physical exam
reveals a well developed, well nourished pale child. There is slight plenomegaly and hepatomegaly with generalized enlarged lymph nodes. Scattered
petechiae are seen on the legs.
| WBC 18 X 103 |
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RBC 2.76 |
Tdt = positive |
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Percent Abs |
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HGB 6.6 |
CD10 (Calla) = positive |
| NE 6.2
1.08 |
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HCT 19.1 |
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| LY 90.5
16.2 |
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MCV 84.4 |
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| MO 2.8
0.5 |
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MCH 29.9 |
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| EO 0.5
0.1 |
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MCHC 35.5 |
Reference values? |
| BA
0 0 |
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RDW 17 |
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| Immature lymphs |
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PLT 26 X 103 |
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MPV 7.4 |
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Click the green box in the smear above to see the slide using the virtual
microscope. Describe what you see and then answer the following questions.
- What features of the lymphocytes suggest
they are malignant?
- What clinical features of this girl
suggest this is a leukemia?
- How do we distinguish ALL form AML?
- What will the bone marrow show?
- Would expect the cells to be positive
for PH1
chromosome?
- What treatments exist for this
condition?
- Why should one be cautious of uric acid
levels during treatment?
- Prognostic indicators for this disease?
Next patient is a
woman with a positive hemoccult test. |
Lymphoblasts positive for
terminal DNA transferase (Tdt).
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