BIOLOGY 2D03 Lecture Notes - Lecture 10: World Health Organization, Immunophenotyping, Blood Film
19 Jun 2018
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Height and weight: Normal
Cardio: Her pulse is 96 bpm and heart sounds are normal, but she has a grade 2 systolic
murmur located at the left sternal edge (flow murmur due to anaemia).
Resp: Her chest is clear.
Abdo: In the abdomen there is 4cm hepatomegaly and her spleen is palpable 2cm below
the left costal margin.
ENT: Her left eardrum is dull and pink but the right is normal, as is her throat.
Musc: Although she resists movement of her joints, there is no obvious swelling,
deformity or overlying skin change.
Investigations
FBC – anaemia, thrombocytopenia and neutropenia. White blood cell (WBC)
count may be high, normal or low in leukaemia.
Blood film – detailed morphology of all cell lines
Viral titres – hepatitis, Epstein–Barr, parvovirus (usually causes red cell aplasia)
CXR- check for mediastinal mass
BM aspirate– to assess morphology and cellularity of the cells. Blast cells on the
film would be indicative:
o World Health Organization (WHO) classification= 20% or greater
amount of blasts in bone marrow and/or peripheral blood for the
diagnosis of ALL
Immunophenotyping helps to determine subtype - B or T cell.
Differential Diagnosis- pancytopenia
JWH, JM, AJS
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Document Summary
Cardio: her pulse is 96 bpm and heart sounds are normal, but she has a grade 2 systolic murmur located at the left sternal edge (flow murmur due to anaemia). Abdo: in the abdomen there is 4cm hepatomegaly and her spleen is palpable 2cm below the left costal margin. Ent: her left eardrum is dull and pink but the right is normal, as is her throat. Musc: although she resists movement of her joints, there is no obvious swelling, deformity or overlying skin change. Blood film detailed morphology of all cell lines. Viral titres hepatitis, epstein barr, parvovirus (usually causes red cell aplasia) Bm aspirate to assess morphology and cellularity of the cells. Immunophenotyping helps to determine subtype - b or t cell. Jwh, jm, ajs: leukemia- all due to it accounting for 80% of leukemia(cid:495)s in childhood. Bruising- other sites apart from the shins, petechiae, nose bleeds: bone pain/tenderness due to marrow expansion.
