General and Systemic Histopathology, C601&C602

    Virtual Slide: A 32-year-old white man is referred because of abnormal CBC

    This 32 year-old white man was referred because of an abnormal CBC that was part of his pre-employment physical at a local school. His only complaints were weight loss and fatigue. Physical exam reveals a pale, thin and apprehensive young man. He experienced mild LUQ abdominal pain during the exam, and his spleen was enlarged. No adenopathy was observed.

    WBC  89.1 X 103   RBC    2.85  
           Percent    Abs   HGB    8.4  
    NE    89.5     79.8   HCT     23.9  
    LY      5.6       5.0   MCV     83.8  
    MO     2.3       2.0   MCH     29.6  
    EO      2.6      2.3   MCHC   35.3  
    BA        0         0   RDW     15.8  
    Many immature cells   PLT      565 X 103 Reference values?
        MPV      8.4  
    Click the red + in the smear above to see the slide using the virtual microscope. Describe what you see and then answer the following questions.
    • Define a myelproliferative disorder (MPD).
    • What's the most likely diagnosis here?
    • How would you confirm it?
    • What is the PH1 chromosome?
      • In what cells do you find it?
      • Click the image to the right for more info.
    • What would the marrow look like.
    • What's with his big spleen?
    • What would a serum vitamin B12 show?

    The next patient complains of fever.


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