HEMATOPATHOLOGY MODULE Prepared by Emmanuel R. de la Fuente, M.D.

SITUATIONAL ANALYSIS NO.1

RJ, a 22 yr. old man had a routine complete blood count.

Slide 1. RJ’s peripheral blood smear showed the following cells. Identify and describe the red blood cells. leukocytes, and platelets.

The complete blood count was reported as normal. What does a normal CBC and leukocyte differential count mean? Discuss also the following: 1.Origin and development of these cells 2.Control of hematopoiesis

Slide 2. Normal bone marrow biopsy. Estimate the fat to cell ratio in A. Identify and describe the precursor cells of the peripheral blood cells in pictures B, C, and D (next slide). A B

C D Slide 3

SITUATIONAL ANALYSIS NO.2

A 32 year old man complaining of easy fatigability underwent a bone marrow biopsy because of an abnormal peripheral blood smear.

Slide 1. Describe the bone marrow biopsy.

1.Describe the probable peripheral blood count. 2.Predict the other clinical signs and symptoms of the patient and the pathophysiologic basis. 3.Give the probable diagnosis of the case based on the bone marrow biopsy. 4.Discuss the etiopathogenesis.

SITUATIONAL ANALYSIS NO. 3

A 25 year old man complained of easy fatigability, weakness, and spontaneous gum bleeding. A bone marrow biopsy was performed.

Slide 1. Which of the two biopsies can explain the signs and symptoms of the patient? Describe each and explain your choice. A B

Slide 2. The peripheral blood smear showed this cell type with a count of 75,000/cu.mm. Which of the 2 previous bone marrow biopsies would be consistent with this blood picture. Describe the cells below..

Physical examination revealed slightly enlarged cervical and axillary lymph nodes and liver. The spleen was not palpable.

Discuss the following: 1.Probable CBC picture 2.Correlation of bone marrow and blood picture with the signs and symptoms 3.Possible diagnoses 4.Possible etiopathogenesis of the lesion 5.Outcome

SITUATIONAL ANALYSIS NO. 4

A 52 year old woman complained of chronic back pains. CBC showed moderate anemia. A bone marrow biopsy was done.

A B C Slide 1. Bone marrow biopsy: A. low and B. high magnifications. C. bone marrow aspirate. Identify the cells and describe.

Slide 2. Typical X-ray picture and skull lesions of this disease. Identify the lesions and describe.

Discuss the following: 1.Etiopathogenesis of the disease 2.Pathophysiologic basis of signs and symptoms based on bone marrow picture 3.Immunologic characteristics of cells 4.Outcome

SITUATIONAL ANALYSIS NO. 5

An 8 year old boy had bilateral cervical lymphadenopathies. Chest X-ray showed enlarged hilar lymph nodes. A cervical lymph node biopsy was done.

Slide 1. Identify and describe the lesion. Is it benign or malignant? Discuss histologic basis.

Discuss the following: 1.Etiopathogenesis 2.Predominant type of lymphocyte involved in the lesion

Slide 2. If this is the lesion, identify the cells. Is it benign or malignant? Give basis for choice. A. low B. high magnification.

Discuss the following: 1.Probable diagnosis 2.Etiopathogenesis 3.Classification of lesion 4.Basis of staging 5.Outcome

Slide 3. If the lesion shows this type of cell, what is the probable diagnosis?

Discuss the following: 1.Probable diagnosis 2.Etiopathogenesis of the lesion 3.Classification of the disease 4.Basis of staging 5.Outcome