Case Studies in Hematology - Malignant WBC Disorders
Continuing Education Credits
This course presents case studies pertaining to malignant/neoplastic disorders. Each case is presented, followed by several pertinent questions. Answers for each question are then given, along with a brief discussion to explain these answers. The course taker will then have the opportunity to answer questions based on the concepts learned in the case.
Objectives
- Correlate laboratory data with patient history, signs, and symptoms.
- Recognize abnormalities in the CBC and other hematology test results as they pertain to the cases presented.
- Upon reviewing the CBC, recognize which of the tests could indicate a possible malignant condition.
- Analyze the laboratory data and other information given in the case.
- Propose possible diagnoses as well as additional laboratory tests which will help to arrive at a definitive diagnosis of the case.
- Explain the pathophysiological concepts of the malignant disorder in each case.
Course Outline
- The 2022 WHO Revision of Hematologic Malignancies
- Introduction to the 2022 WHO Classification of Myeloid and Lymphoid Neoplasms
- 2022 WHO Classification of Lymphoid Neoplasms
- 2022 WHO Classification of Myeloid Neoplasms
- A Three-Year-Old with Acute Lymphoblastic Leukemia: A Review of Current and New Diagnostic Tests
- Three-Year-Old Child Presenting with Bruising, Lethargy, and Fever
- Interpretation of CBC and Additional Testing
- Immunophenotyping in ALL
- Cytogenetic Analysis
- Molecular Testing
- Discussion of Childhood Acute Lymphoblastic Leukemia
- Immunophenotyping is a useful diagnostic technique to determine cell lineage in acute leukemias. Specifically, this technique detects which of the following?
- Some favorable factors (i.e., good prognosis) in childhood leukemias include which of the following?
- According to WHO, what is the percentage of blasts that triggers a diagnosis of acuteleukemia?
- A 72-Year-Old Male with Plasma Cell Myeloma
- Patient Symptoms and Initial Testing
- Discussion and Further Testing
- Further Identification of the M Protein
- Testing for Prognostic Indicators
- Pathophysiology of Plasma Cell Myeloma
- Symptoms and Treatment of Plasma Cell Myeloma
- Which of the following is not a symptom of plasma cell myeloma?
- Match the result commonly seen in plasma cell myeloma to the laboratory test. Note that not all of these are found in every plasma cell myeloma patient.
- Fluorescence In Situ Hybridization (FISH) is a laboratory test frequently performed on plasma cell myeloma patients. This test detects which of the following?
- Controversial Diagnosis of Essential Thrombocythemia of a 68-Year-Old Patient
- Initial Laboratory Tests and Presenting Symptoms
- Results of Follow-up Tests and More Testing
- More Tests and a Diagnosis
- Pathophysiology of Essential Thrombocythemia (ET)
- Symptoms and Treatment of ET
- Is This Really the Correct Diagnosis?
- Common laboratory findings at initial diagnosis of essential thrombocythemia (ET) include:
- The following criteria must be excluded in order to establish a diagnosis of ET:
- Which of the following diseases is difficult to distinguish from ET?
- A 77-Year-Old Man with Dysplasia and Blasts: Myelodysplastic Neoplasm with Increased Blasts-2 (MDS-IB2)
- Symptoms and Initial CBC
- Differential
- Discussion of Results and Further Testing
- Definitive Diagnosis
- Pathophysiology of Myelodysplastic Neoplasms (MDS)
- Pathophysiology of MDS-IB2
- Clinical Course, Prognosis and Treatment of MDS-EB2
- Check all of the laboratory results that can be seen in MDS.
- Which of the following white blood cell morphologies can be seen in MDS-IB2?
- References
- References
Additional Information
Level of instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Author: Margaret Reinhart, MS, MLS(ASCP), is an adjunct instructor of Hematology at the Pennsylvania Hospital Medical Laboratory Science program, which is part of the Hospital of the University of Pennsylvania. From 1990 to 2020, she was the Medical Laboratory Science Program director at the University of the Sciences.
The author has no conflict of interest to disclose.
Reviewer: Joshua J. Cannon, MS, MLS(ASCP)CMSHCM received his Bachelor
of Science and Master of Science in Medical Laboratory Science from Thomas
Jefferson University in Philadelphia, PA. He holds Medical Laboratory Scientist
and Specialist in Hematology certifications through the ASCP Board of
Certification. He was a professor at Thomas Jefferson University for seven
years before transitioning into his current role as Education Developer at
MediaLab by Vastian. His areas of expertise and professional passions include
clinical hematology and interprofessional education.