Muhammed spleen is palpable

Muhammed spleen is palpable

1. Differences between

   • leukocytosis: increase in the number of WBCs .' non neoplastic"
     • Neutrophilic leukocytosis: (count >7000cells/ mm3)
       • Bacterial infections- Corticosteroids (inhinit margination) -Myocardial infarction
     • Lymphocytosis: (Absolute count >4000cells/ mm3
       • Viral infections (infectious mononucleosis) -Drugs (phynetoin)
     • Eosiniophilia
       • Type I hypersensitivity reaction (bronchial asthma- reaction to penicillin)- Helminthic infection
     • Monocytosis
       • Chronic infections : TB
   • leukomoid reaction:This is a reactive and excessive leukocytosis."mimic leukemia"
     • WBC counts up to 15 - 100,000/mm3
     • Shift to the left (immature WBCs)
     • Signs of activation Doehle bodies, toxic granulations (Differs the condition from CML)
       • toxic granulation
       • Doehle bodies
       • NAP scores high (Differs the condition from CML)
       • MPO negative (Myeloperoxidase) to differ from CML

2. Hematological neoplasms

3. Hematological History Taking

4. Hematology Physical Examination

5. Chronic Myeloid Leukemia

   • phases
   • confirming tests
     • FISH
     • PCR
     • Karyotyping
     • Bone Marrow Biopsy in accelerated phase
   • presence of Philadelphia chromosome 22 due to translocation
     • Fusion of 2 genes: BCR (or chromosome 22) and ABL1 (on chromosome 9), resulting in BCR-ABL1 fusion gene
   • Management
     • tyrosine kinase inhibitor
       • imatinib
         • inhibit TK enzyme
     • Hematopoietic stem cell transplantation
   • clinical presentation
     • Asymptomatic
     • abdominal fullness due to splenomegaly
     • weight loss - fatigue

6. Investigations

   • CBC
   • Blood film
     • Blood film at 1000X magnification shows a promyelocyte, an eosinophil, and 3 basophils.
     • Blood film at 400X magnification demonstrates leukocytosis with the presence of precursor cells of the myeloid lineage. In addition, basophilia, eosinophilia, and thrombocytosis can be seen.

Images and files in the map