"Case 10"

Case 10

Case 10

History:

82 year old female. Brought to Emergency Room with symptoms of severe frontal headache and associated confusion. Noted to have decreased energy level and a 15 pound weight loss over the previous three months.

The patient was initially evaluated for a possible CVA. Neurologic exam and CT scans were negative, but she was found to be pancytopenic.

Case 10

Physical Exam:

Pale appearing, but otherwise within normal limits. No organomegaly.

Slide 4

CBC

RBC 2.05 x 10[12]/L

HGB 6.6 g/dL

HCT 19.9 %

MCV 97.1 fL

MCH 32.2 pg

MCHC 33.2 g/dL

RDW 16.4

WBC 3.5 x 10[9]/L)N 48 % L 34 M 15 E 3 B0(

PLT 55 x 10[9]/L

"Question"

Questions

What morphologic alterations are seen in this blood smear field?

What further laboratory studies, if any, are indicated?

What is the most likely diagnosis?


	History:
	82 year old female. Brought to Emergency Room with symptoms of severe frontal headache and associated confusion. Noted to have decreased energy level and a 15 pound weight loss over the previous three months.
	The patient was initially evaluated for a possible CVA. Neurologic exam and CT scans were negative, but she was found to be pancytopenic.


	Physical Exam:
	Pale appearing, but otherwise within normal limits. No organomegaly.


	RBC 2.05 x 10[12]/L
	HGB 6.6 g/dL
	HCT 19.9 %
	MCV 97.1 fL
	MCH 32.2 pg
	MCHC 33.2 g/dL
	RDW 16.4
	WBC 3.5 x 10[9]/L)N 48 % L 34 M 15 E 3 B0(
	PLT 55 x 10[9]/L