CASE STUDIES in RBC Disorders

Dr.CSBR.Prasad, M.D.,

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Case-1

• 8month old infant with 2week history of swollen hands and feet

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Case-1

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Case-1 Peripheral blood smear

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Case-1

1. What are the x-ray findings?

2. How do you describe the hand?

3. What is the abnormality in the peripheral smear?

4. How do you confirm your diagnosis?

5. How do you prevent future recurrent complications of this disease?

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Case-2

• 29yo male. Incidental finding in routine hemogram. What is your interpretation?

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Case-2

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Case-2

• How do you confirm your suspicion?

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Case-3

• 60yo male with weakness and pallor.

• Hemogram and PBS are given for your interpretation.

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Case-3

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Case-3 PBS

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Case-3

1. What are the significant abnormal values in hemogram report?

2. What are your PBS findings?

3. What is your diagnosis?

4. What do you do next?

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Case-4

• 60yo female with chronic severe joint pains and deformity was found to have HGB=8gm/dl, MCV=68fl, serum iron=100µg/dl

• Peripheral smear and BM are given for your interpretation

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Case-4

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Case-4 PBS

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Case-4 BM, Perl’s stain

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Case-4

1. How do you describe the appearance of the hand ?

2. Describe the peripheral blood smear

3. What is being demonstrated in the Bone marrow smear? Is it normal or altered?

4. What is your diagnosis?

5. What is the basic pathology in this disease?

6. What should be the main stay of treatment?

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Case-5

• 40yo female with weakness and very mild jaundice and recent onset foot drop

• Hemogram and PBS and BM images are given for your interpretation

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Case-5 Hemogram

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Case-5 PBS

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Case-5 BM

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Case-5 BM

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Case-5 BM

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Case-5 BM

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Case-5

1. What are the striking abnormalities in hemogram values?

2. What are your findings in PBS, BM smears?

3. Why this patient has foot drop?

4. How do you assess the response to treatment in these cases?

5. How do you explain jaundice in this patient?

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Case-6

• 35yo female with chronic anemia and whitish skin lesions and indigestion

• Gastric biopsy was done

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Case-6 Skin lesions

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Case-6 Section from stomach

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Case-6 PBS

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Case-6

1. Enumerate the histological findings in stomach biopsy

2. What are the PBS findings?

3. What is your diagnosis?

4. What is the importance of finding shown in the clinical photograph of the patient?

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Case-7

• 40yo male patient complains of passing red colored urine after consuming beans shown in the image.

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Case-7

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Case-7 B - Patient’s urine sample A - Normal urine for comparison

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Case-7 PBS

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Case-7 Reticulocyte preparation

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Case-7

1. Describe the abnormality in urine sample

2. What are your findings in retic prep?

3. Describe the typical cells shown in the peripheral blood

4. How do you confirm the diagnosis?

5. Which famous mathematician suffered from this disease?

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Case-8 Urine samples from a patient What is your diagnosis?

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Case-9

• 18yo boy with h/o jaundice since birth

• Operated for Gall stones recently

• Sectioned gall bladder and PBS images are given for your interpretation

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Case-9

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Case-9 PBS

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Case-9

1. What are your findings in the gall bladder?

2. What are your findings in the peripheral smear?

3. What is your diagnosis?

4. What test will help in establishing the diagnosis?

5. What one may find in the abdominal examination?

6. Name some other causes for PBS findings

7. What are the other causes for gall bladder findings

8. Can you name some causes for “jaundice since birth”

9. After what period “neonatal jaundice” becomes worrysome?

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Case-10 Patient’s spun

blood sample and micro-HCT tubes

(Arrows). What are the

causes for such a finding?

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Case-11

• Child with chronic microcytic hypochromic anemia

• Blood and BM images are given

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Case-11 PBS & BM

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Case-11

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Case-11

1. What is your diagnosis?

2. What are the differentials for microcytic hypochromic anemia?

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Case-12

• A child with hemolytic anemia

• After a brief illness his anemia worsened

• Clinical image, BM pictures are given for your interpretation

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Case-12 BM

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Case-12 BM aspirate

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Case-12 BM biopsy

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Case-12

• What are the BM findings?

• How do you treat these cases?

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Case-13

• 40 yo female with muscle weakness and anterior mediastinal tumor

• Chest CT and BM images are given for interpretation

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Case-13 Chest CT

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Case-13 BM

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Case-13 BM

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Case-13

1. What are the CT findings?

2. Name some DDs for anterior mediastinal mass

3. What are the BM findings?

4. What is your diagnosis?

5. How do explain muscle weakness in this patient?

6. What are the other causes for this type of BM changes?

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Case-14 15yo female with chronic anemia

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Case-14 PBS

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Case-14

1. What is the descriptive term used for the facial appearances in this case?

2. Describe the changes in skull X-ray?

3. What are the findings in peripheral blood smear?

4. What is your diagnosis?

5. How do you confirm the diagnosis?

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Case-15 50yo male with a HGB=11gm/dl. PBS given for your interpretation.

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Case-16 How do you prove it’s hereditary?

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Skull from Italian excavation site

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Case-17 Paleopathology case

Case-17 Clue: Bottom image

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1. Describe the abnormality seen in the skull

2. What are the causes for such changes

3. How do you interpret the findings in the bottom image

4. What is your probable diagnosis?

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Case-17 Paleopathology case

E N D

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Please make an attempt to get the right answers

For answers contact: Dr.CSBR.Prasad, M.D.,

Associate Professor,

Deptt. of Pathology,

Sri Devaraj Urs Medical College,

Kolar-563101,

Karnataka

<CSBRPRASAD@rediffmail.com>

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