Case 1
Patient: 89-year-old male
Clinical details: Extreme fatigue
Blood count: Haemoglobin 98 g/L, white cell count 12.9 x 109/L, platelet count 132 x 109/L
Questions
Describe the main features of the blood film.
What is the most likely diagnosis?
What features in the patient’s clinical history are important in making the diagnosis?
Morphology
Blood film
Case 2
Patient: 24-year-old male
Clinical details: Fatigue and fever
Blood count: Haemoglobin 103 g/L, white cell count 28.9 x 109/L, platelet count 62 x 109/L
Questions
Describe the main features of the blood and bone marrow aspirate.
What is the most likely diagnosis?
What makes this diagnosis unique?
How can you confirm the diagnosis?
Morphology
Blood film
Bone marrow aspirate
Case 3
Patient: 71-year-old female
Clinical details: Unexplained anaemia
Blood count: Haemoglobin 96 g/L, white cell count 3.1 x 109/L, platelet count 141 x 109/L
Questions
Describe the main features of the blood and bone marrow aspirate.
What are the key clinical features that should be used in establishing the diagnosis?
Her next generation panel shows an ASXL1 mutation. What is the significance of this result?
Morphology
Blood film
Bone marrow aspirate
Case 4
Patient: 61-year-old male
Clinical details: Unexplained anaemia, blood film shows macrocytosis
Blood count: Haemoglobin 64 g/L, white cell count 5.2 x 109/L, platelet count 217 x 109/L
Questions
Describe the main features of the bone marrow aspirate and trephine biopsy.
Provide a differential diagnosis.
What potential therapeutic approaches can be suggested for the management of his anaemia?
Morphology
Bone marrow aspirate
Bone marrow biopsy
Case 5
Patient: 21-year-old male
Clinical details: Headache and visual disturbance
Blood count: Haemoglobin 121 g/L, white cell count 311.7 x 109/L, platelet count 246 x 109/L
Questions
Report the blood film and bone marrow aspirate.
Provide an initial management plan.
Morphology
Blood film
Bone marrow aspirate
Case 6
Patient: 61-year-old female
Clinical details: Recent stroke
Blood count: Haemoglobin 141 g/L, white cell count 9.1 x 109/L, platelet count 321 x 109/L
Questions
What additional investigations should be used to formulate a diagnosis.
What additional investigations should be used to formulate a diagnosis.
Provide an initial management plan.