RT Book, Section
A1 Hillman, Robert S.
A1 Ault, Kenneth A.
A1 Leporrier, Michel
A1 Rinder, Henry M.
SR Print(0)
ID 1127766055
T1 THE DYSPLASTIC AND SIDEROBLASTIC ANEMIAS
T2 Hematology in Clinical Practice, 5e
YR 2016
FD 2016
PB McGraw-Hill Medical
PP New York, NY
SN 9780071626996
LK hemonc.mhmedical.com/content.aspx?aid=1127766055
RD 2024/04/18
AB CASE  HISTORY  •  Part  1A  65-year-old  woman  seen  for  a  routine  checkup  reports  a  decrease  in  exercise  tolerance,  especially  during  routine  workouts  at  the  gym.  She  denies  other  recent  illness.  Review  of  systems  is  positive,  however,  for  a  history  of  Hodgkin  lymphoma,  stage  IA,  diagnosed  at  age  25  and  treated  successfully  with  mantle  radiation.  Physical  examination  reveals  a  well-developed  white  female  looking  younger  than  her  stated  age.  Conjunctiva  may  be  somewhat  pale.  No  evidence  of  lymphadenopathy  or  hepatosplenomegaly.  No  recent  weight  loss.CBC:  Hemoglobin/hematocrit  -  10  g/dL/30%MCV  -  99  fL  MCH  -  32  pg  MCHC  -  33  g/dLRDW-CV  -  16%White  blood  cell  count  –  4,900/μLTable  Graphic  Jump  Location|Download  (.pdf)|PrintAbsolute  differential:Neutrophils  -  2,600/μLLymphocytes  -  2,100/μLMonocytes  -  200/μLPlatelet  count  -  180,000/μLSMEAR  MORPHOLOGYSlightly  macrocytic,  normochromic  with  1+  aniso-  and  poikilocytosis.  Few  if  any  polychromatic  macrocytes  observed.  Leukocytes  are  normal  except  for  occasional  bilobed  cells  (Pelger-Huët  anomaly).  Platelets  appear  somewhat  pale—poorly  granulated.Reticulocyte  count/index  -  1.2%/<1.0QuestionsHow  should  the  CBC  findings  be  described?What  additional  studies  should  be  ordered?