Name: Anna Gorringe

Theme: CML and CLL

OPTION LIST

A	Pelger-Heret cells	I	Chromosome 11q23 deletion
B	Chromosome 9;22 translocation	J	Spherocytes
C	Reed-Sternberg cells	K	Platelets
D	Auer rods	L	Blast cells
E	Chromosome 13q14deletion	M	Clonal B lymphocytes
F	Neutrophils	N
G	Reticulocytes	O
H	Eosinophils	P

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

1. A 50yr old man presents to his GP complaining of weight loss, tiredness, easy bruising and a painful big toe. On examination his spleen is massively enlarged. Investigation shows a raised serum urate. The peripheral blood film is abnormal, showing proliferation of which type of cell?

2. A 65yr old lady is seen in the haematology clinic where she has been treated for 7 years with Imantinib for chronic myeloid leukaemia. Having been previously well, she is now complaining of shortness of breath and general weakness. Examination reveals splenomegally. Her peripheral blood film has changed from previous appointments and reflects the progression of her disease. Which type of cell is now proliferating?

3. A 70yr old man complains of a year’s history of fatigue, weight loss and recurrent sinusitis. His white cell count is raised with a lymphocytosis of 283x10⁹ /L. Blood film shows features of haemolysis and Coomb’s test is positive. Further investigation show the bone marrow, blood and lymph nodes are infiltrated with which cell population?

4. A routine full blood count on a 62yr old gardener reveals a high white cell count of 154x10⁹ /L, and the differential shows this to be a neutrophilia. The haemoglobin and platelet count are normal. Biopsy shows a hypercellular “packed” bone marrow, and cells show the presence of which chromosomal abnormality?

ANSWERS

1. F

2. L

3. M

4. B

5.