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  #1  
Old 10-20-2009
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Star Photo-quiz

Photo-quiz-cell.jpg
Identify the abnormality in the picture. Give the diagnosis. This patient was asymptomatic and this abnormality was found on routine blood work-up. What is the next line of management?
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Last edited by Sabio; 12-16-2009 at 09:54 AM.
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  #2  
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Is that a smudge cell seen in chronic lymphocytic leukemia?
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Default Basket cells in CLL

thats what that is
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both of u r right...its a smudge/basket cell seen in CLL...whats the next line of management??
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How come the patient had no symptoms!
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CLL usually has no symptoms in early stages..its found only incidentally by lymphocytosis and on peripheral smear in these stages..And later on patients present with fatigue and lymphadenopathy...Severe cases present with anemia and thrombocytopenia manifestations(Ref- CMDT 2010)

Anybody answering abt the management of this patient?
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Quote:
Originally Posted by docspike View Post

Anybody answering abt the management of this patient?
It seems that nobody can answer the management part
why don't you tell us
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Mangement guided by-
Rai classification system

# stage 0, lymphocytosis only
# stage I, lymphocytosis plus lymphadenopathy
# stage II, organomegaly
# stage III, anemia
# stage IV, thrombocytopenia

Most cases of early indolent CLL require no specific therapy, and the standard of care for early stage disease has been observation.

Indications for treatment include progressive fatigue, symptomatic lymphadenopathy, or anemia or thrombocytopenia

symptomatic and progressive Rai stage II disease or stage III/IV disease-initial treatment of choice is the combination of the chemotherapeutic agent fludarabine plus the antibody rituximab, with or without the addition of the chemotherapeutic drug cyclophosphamide

In the case given, the patient is asymptomatic and only has lymphosytosis-->stage 0-->no intervention, observation is the answer...

Ref-CMDT 2010
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Last edited by docspike; 10-20-2009 at 11:30 PM. Reason: its stage 0...made a mistake in hurry..
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Old 10-23-2009
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Default we should have more photo quiz

read this own my own so i did not know how to manage it, thanks for the great information, NEXT Questions please..
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Quote:
Originally Posted by docspike View Post
Identify the abnormality in the picture.Give the diagnosis.This patient was asymptomatic and this abnormality was found on routine blood work-up.What is the next line of management?
Smudge cells are ruptured CLL cells right? Are there any other kind of smears that would look similar to this CLL diagnosis? Or is this unique to only CLL?
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Quote:
Originally Posted by lemontea88 View Post
Smudge cells are ruptured CLL cells right? Are there any other kind of smears that would look similar to this CLL diagnosis? Or is this unique to only CLL?
ya they are due to rupture of fragile lymphocytes during preparation of slide..this phenomenon can be seen in reactive lymphocytosis, seen in some infections...but for exam purpose, its hallmark of CLL(this is seen more frequently in this because of fragility/membrane disorder)
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