Pathology Conference Corner

 

Hematology - Case #1

By: Matthew R. Fries, MD

Case Report

A 6 year old white female presented to her private pediatrician with a 1 week history of sore throat and congestion. Physical exam and ultrasonography revealed hepatosplenomegaly with the spleen extending into the pelvis.

The child was active and generally healthy with an unremarkable past medical and developmental history except for a few episodes of otitis media and a tendency to bruise easily. The child denied abdominal complaints. An older sister and two healthy half siblings are healthy. Weight was in the 25th to 50th percentile and height in the 5th percentile. She had normal vital signs, shotty cervical lymphadenopathy, and a benign ocular and neurological examination.

 

Selected Laboratory Results:

Analyte

Value

Reference Range

Hemoglobin
10.8 g/dl
(13.5 - 18 g/dl)

Platelets
70x103/µL
140-450x103/µL

White Blood Cell Count (WBC)
3.1 mg/dl
(4.1-10.9x103/µL)
Diff

Polymorphonuclear Cells (polys)
45%
35-80%
Immature Polys (bands)
5%
0-10%
lymphocytes (lymp)
41%
20-50%
monocytes (mono)
6%
2-12%
eosinophils (eos)
3%
0-7%
basophils (bas)
0%
0-2%

Reticulocytes
0.7%
0.5-1.5%

A bone marrow aspirate and biopsy was performed.

Pathology

Specimen #1: "Bone Marrow Aspirate"

low power (114K jpeg)

 

high power (101K jpeg)

Specimen #2: "Bone Marrow Biopsy"

low power (189K jpeg)

 

high power (174K jpeg)

Additional Studies

Diagnosis

Discussion

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Last modified: Jan 2, 1997