NORMAL BLOOD VALUES. SHEIKHA NORMAL HEMATOLOGICAL VALUES.

NORMALBLOOD VALUES

SHEIKHA

NORMAL

HEMATOLOGICAL

VALUES

10 trillion “1013” new blood cells must be replaced Each day to maintain steady state blood counts!

This is equivalent to an annual number of cells approximating the total body weight, but the totalbone marrow of an adult human contains around1012 cells, 10 fold less than the daily need!

Marrow contains 1 stem cell per 20 million nucleated cells

Normal Normal

ValuesValues

MEN WOMENCORD

CHILD 3 m

RCC+/- 0.5X1012/L

5.0 4.3 5.0 4.0

HbHbgm/dLgm/dL

13.0 13.0 toto

17.017.0

12.0 12.0

15.015.0

13.5 13.5 toto

19.519.5

9.59.5

13.513.5

Hct.Hct.

(PCV)(PCV)

40%40%

54%54%

36%36%

46%46%

44%44%

64%64%

32%32%

44%44%

MCV (fL)MCV (fL) 76-76-9696

76-9676-96 106106 9696

The Sheikhas

1818 cubic meters

1800 kilos

Normal ValuesNormal Values

= ------------ = ------------ == ------------ = ------------ =

= ------------ = -------- = 90 fL= ------------ = -------- = 90 fL

Mean Cell VolumeMean Cell Volume

0.45 L

5.0 x 1012

0.45 x 1015 fL

5.0 x 1012

NORMAL MCV = 76 – 96 fL

SHEIKHA

Normal Normal ValuesValues

= ------------ = ------------ == ------------ = ------------ =

= ----------- = ------------ = 30 pg = ----------- = ------------ = 30 pg

Mean Cell Mean Cell HemoglobinHemoglobin

15 gm/dL

5.0 x 1012/L

150 gm/L 150 x 1012 pg

5.0 x 1012/L

NORMAL MCH = 27 – 32 pg

SHEIKHA

15gm/dL

5 trillion

1 Liter

Normal ValuesNormal Values

= ------------ = ------------ == ------------ = ------------ =

= 333 g/L = 33 g/dL= 333 g/L = 33 g/dL

Mean Cell VolumeMean Cell Volume

150 g/L

0.45 L/L

NORMAL MCHC IN ADULTS & CHILDREN = 32 – 36 g/dL

SHEIKHA

0.45150gm

RETICULOCYTE COUNTRETICULOCYTE COUNT

0.2 to 2.0%

=10,000 to 100,000/uL (Adults & Children)

2.0 to 6.0%Mean = 150,000

(Infants/ Cord Blood)

BLOOD VOLUMEBLOOD VOLUME

60 to 80 ml/Kg60 to 80 ml/Kg

PLASMA

40 to 50 ml/Kg

Men: 25 to 35 ml/KgWomen: 20 to 30 ml/Kg

SHEIKHA

Differential White Cell CountsDifferential White Cell Counts

Total WBC: Total WBC: 4.0 to 11.0 X 104.0 to 11.0 X 109 9 / L/ L

4,000 to 11,000 / uL4,000 to 11,000 / uL

Neutrophils

Lymphocytes

Monocytes

Eosinophils

Basophils

2,000to

7,500/uL1,500

to4,000/uL

SHEIKHA

BLOOD CELLS LIFE SPANBLOOD CELLS LIFE SPAN

10 days

120days T1/2

7 hours

RBCWBC

Platelet

SHEIKHA

Iron statusIron status

Serum Iron UIBC

13 – 32 umol /L

100 ug /L

45 – 70 umol /L

300 ug /L

Male: 30-300 ug/L Female: 15-200

FERRITIN

SHEIKHA

CBCCBC

NormalNormal

M: 13-17 M: 13-17 F: 12-15F: 12-15

M: M: 40-54%40-54% F: F: 36-46%36-46%

+/- 0.5+/- 0.5 M: M: 5X105X101212/L/L F: F: 4.3X104.3X101212//LL

76-9676-96

27-3227-32

32-3632-36

0.2-2.00.2-2.0

11.5-14.511.5-14.5

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

NormalNormal

4,000 – 11,000/uL4,000 – 11,000/uL2,000 – 7,500/ uL2,000 – 7,500/ uL

1,500 – 4,000/1,500 – 4,000/ uL uL200 – 800/ uL200 – 800/ uL

40 – 440/ uL40 – 440/ uL

<100/ uL<100/ uL

WBCWBCNeutrophilsNeutrophils

LymphocyteLymphocytess

MonocytesMonocytes

EosinophilsEosinophils

BasophilsBasophils

Blasts:Blasts:

PromyelocytePromyelocytes:s:

Myelocytes:Myelocytes:

MetamyelocyteMetamyelocytes:s:

Band or Band or Stab:Stab:

NormalNormal

150,000 – 150,000 – 400,000/uL400,000/uL

5.0 - 8.0 fL5.0 - 8.0 fL

0.1 - 0.4 %0.1 - 0.4 %

PlateletsPlatelets

MPVMPVPlateletcriPlateletcritt

PDWPDW

Platelet in Platelet in smearsmear

200 X 109/L X 5 fL= 1000 X 109 fL of platelets/L of blood =1.0 X 1012 fL/L = 1 ml of platelets/L of blood =

400 X 109/L X 8 fL= 3200 X 109 fL of platelets/L of blood = 3.2 X 1012 fL/L = 3.2 ml of platelets/L of blood =

Total Platelet Mass in an adult ~ 5 to 20 mls

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

Platelets

MPVPlateletcrit

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

Platelets

MPVPlateletcrit

CLINICAL AND LAB.DATA

Case 1HAYASA50 years

Patient: Back Pain Smear: Rouleaux Marrow: 80% PCs ESR: 110 mm/hr

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic.

RDWRDW

12.012.0

0.350.35

4.04.0

1515%%

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

4.44.4

60%60%

30%30%

Platelets

MPVPlateletcrit

200,000

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

12.012.0

0.350.35

4.04.0

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

4.44.4

60%60%

30%30%

Platelets

MPVPlateletcrit

200,000

MULTIPLE MYELOMA

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.280.28

4.04.0

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

11.011.0

55%55%

35%35%

Platelets

MPVPlateletcrit

8,008,0000

10100.0080.008

CASE 2

ALI HADI3 years

BruisesEpistaxisHematuria

Mild splenomegaly

Marrow full of Megakaryocytes

Smear: Few Giant platelets

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.0

0.280.28

4.04.0

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

11.011.0

55%55%

35%35%

Platelets

MPVPlateletcrit

8,008,0000

10100.0080.008

CASE 2

ALI HADI3 years

BruisesEpistaxisHematuria

Mild splenomegaly

Marrow full of Megakaryocytes

Smear: Few Giant platelets

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

4.04.00.120.12

1.251.25

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

8.08.0

60%60%

30%30%

08%08%

02%02%

Platelets

MPVPlateletcrit

200,00200,0000

770.14%0.14%

Case 3

Abu Bakr30 years

IndianSevere pallorGiven 3 units of RBC

Marrow devoid of RBC precursors

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

4.04.00.120.12

1.251.25

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

8.08.0

60%60%

30%30%

08%08%

02%02%

Platelets

MPVPlateletcrit

200,00200,0000

770.14%0.14%

Case 3

Abu Bakr30 years

IndianSevere pallorGiven 3 units of RBC

Marrow devoid of RBC precursors PRCA

Pure Red Cell Aplasia

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.0

0.350.35

4.34.3

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

166166

40%40%

25%25%

10%10%Platelets

MPVPlateletcrit

400,00400,0000

770.28%0.28%

Case 4

Sultan48 years

Loss of weightModerate splenomegalyMild hepatomegaly

Positive Philadelphia chromosome

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.0

0.350.35

4.34.3

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

166166

40%40%

25%25%

10%10%Platelets

MPVPlateletcrit

400,00400,0000

770.28%0.28%

Case 4

Sultan48 years

Loss of weightModerate splenomegalyMild hepatomegaly

Positive Philadelphia chromosome CML

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

15.015.0

0.450.45

5.05.0

1.5%1.5%

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

50%50%

10%10%

16%16%Platelets

MPVPlateletcrit

200200

12120.12%0.12%

Case 5Yahia

20 years

Hyperpyrexia

Streptococcal tonsillitis

High NAP score

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

15.015.0

0.450.45

5.05.0

1.5%1.5%

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

50%50%

10%10%

16%16%Platelets

MPVPlateletcrit

200200

12120.12%0.12%

Case 5Yahia

20 years

Hyperpyrexia

Streptococcal tonsillitis

High NAP score

LEUKEMOID REACTION

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.0

0.220.22

2.82.8

12.012.0

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

15%15%

80%80%

Platelets

MPVPlateletcrit

20,0020,0000

550.01%0.01%

Case 6FAHAD

8 YEARS

FeverChest InfectionGum BleedingPallor

Blood smear & marrow are full of PAS +ve blasts

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.0

0.220.22

2.82.8

12.012.0

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

15%15%

80%80%

Platelets

MPVPlateletcrit

20,0020,0000

550.01%0.01%

Case 6FAHAD

8 YEARS

FeverChest InfectionGum BleedingPallor

Blood smear & marrow are full of PAS +ve blasts ALL

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.280.28

2.92.9

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

2.02.0

40%40%

20%20%

10%10%Platelets

MPVPlateletcrit

100,00100,0000

0.060.06

Case 7Abdul Rahman

16 Years

Anemia not responding to RHypogranular neutrophilsHypercellular marrow12% Marrow Blasts

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.280.28

2.92.9

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

2.02.0

40%40%

20%20%

10%10%Platelets

MPVPlateletcrit

100,00100,0000

0.060.06

Case 7Abdul Rahman

16 Years

Anemia not responding to RHypogranular neutrophilsHypercellular marrow12% Marrow Blasts

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

6.06.00.360.36

6.06.0

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

nRBCnRBC

30%30%

20%20%

40%40%

Platelets

MPVPlateletcrit

300,00300,0000

880.24%0.24%

Case 8SHADI8 Years

Hypochromic microcytic red cellsTarget cellsMarked increase of nRBCHbF= 100%Splenectomized

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

6.06.00.360.36

6.06.0

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

nRBCnRBC

30%30%

20%20%

40%40%

Platelets

MPVPlateletcrit

300,00300,0000

880.24%0.24%

Case 8SHADI8 Years

Hypochromic microcytic red cellsTarget cellsMarked increase of nRBCHbF= 100%Splenectomized

β- THALASSEMIA MAJOR

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

6.06.00.220.22

2.02.0

110110

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

10%10%

60%60%

4%4%Platelets

MPVPlateletcrit

11110.030.03

Case 9SAUD NAIF60 Years

Perianal abscess

Marrow: Hypercellular; Abnormal pronormoblasts & myeloblasts forming majority of the cells

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

6.06.00.220.22

2.02.0

110110

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

10%10%

60%60%

4%4%Platelets

MPVPlateletcrit

11110.030.03

Case 9SAUD NAIF60 Years

Perianal abscess

Marrow: Hypercellular; Abnormal pronormoblasts & myeloblasts forming majority of the cells

Erythroleukemia

(AML M6)

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

10.010.00.260.26

5.25.2

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

70%70%

25%25%

Platelets

MPVPlateletcrit

280,00280,0000

0.170.17

Case 10MAHA RUSHDI

17 Years

Mild Pallor & Jaundice

Positive Family history

Smear: Small & hyper- chromic red cells

High MCHC

+ Osmotic Fragility Test

Moderate splenomegaly

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

10.010.00.260.26

5.25.2

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

70%70%

25%25%

Platelets

MPVPlateletcrit

280,00280,0000

0.170.17

Case 10MAHA RUSHDI

17 Years

Mild Pallor & Jaundice

Positive Family history

Smear: Small & hyper- chromic red cells

High MCHC

+ Osmotic Fragility Test

Moderate splenomegaly

HEREDITARY

SPHEROCYTOSIS

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

9.09.00.300.30

3.23.2

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

46%46%

20%20%

4%4%Platelets

MPVPlateletcrit

400,00400,0000

0.320.32

Case 11SAED AL-NAMI

70 Years

Massive splenomegalyNegative Ph’ ChromosomeMarrow: Hypercellular with agranular & hypogranular neutrophils

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

9.09.00.300.30

3.23.2

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

46%46%

20%20%

4%4%Platelets

MPVPlateletcrit

400,00400,0000

0.320.32

Case 11SAED AL-NAMI

70 Years

Massive splenomegalyNegative Ph’ ChromosomeMarrow: Hypercellular with agranular & hypogranular neutrophils

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.300.30

4.34.3

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

Platelets

MPVPlateletcrit

280,00280,0000

0.170.17

Case 12HUDA RDENY

20 Years

Severe back painSplenic atrophyHb-electrophoresis is pendingTargets & sickle cells

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.300.30

4.34.3

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

Platelets

MPVPlateletcrit

280,00280,0000

0.170.17

Case 12HUDA RDENY

20 Years

Severe back painSplenic atrophyHb-electrophoresis is pendingTargets & sickle cells

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

12.012.0

0.350.35

4.14.1

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

30%30%

18%18%

28%28%

5%5%Platelets

MPVPlateletcrit

380,00380,0000

0.3%0.3%

Case 13ABDU ABDU

24 Years

Massive splenomegaly+ Ph’ ChromosomeStarted on Hydrea

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

12.012.0

0.350.35

4.14.1

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

30%30%

18%18%

28%28%

5%5%Platelets

MPVPlateletcrit

380,00380,0000

0.3%0.3%

Case 13ABDU ABDU

24 Years

Massive splenomegaly+ Ph’ ChromosomeStarted on Hydrea

“Accelerated Phase”

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

12.012.00.350.35

4.14.1

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

82%82%

Platelets

MPVPlateletcrit

300,00300,0000

0.210.21

Case 14Al-Hifzi

18 Years

HemarthrosisNormal P.T.Prolonged APTTNormal Bleeding TimeHIV Positive

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

12.012.0

0.350.35

4.14.1

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

82%82%

Platelets

MPVPlateletcrit

300,00300,0000

0.210.21

Case 14Al-Hifzi

18 Years

HemarthrosisNormal P.T.Prolonged APTTNormal Bleeding TimeHIV Positive

HEMOPHILIA A

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

6.06.00.180.18

2.22.2

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

2.22.2

40%40%

50%50%

Platelets

MPVPlateletcrit

40,0040,0000

990.04%0.04%

Case 15AISHA

17 Years

Huge SpleenFever

Marrow was requested to exclude an intracellular parasitic disease

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

6.06.00.180.18

2.22.2

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

2.22.2

40%40%

50%50%

Platelets

MPVPlateletcrit

40,0040,0000

990.04%0.04%

Case 15AISHA

17 Years

Huge SpleenFever

Marrow was requested to exclude an intracellular parasitic disease Kala Azar

“Visceral Leishmaniasis”

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.00.350.35

4.34.3

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

50%50%

40%40%

Platelets

MPVPlateletcrit

140,00140,0000

880.11%0.11%

Case 16FATMA

48 Years

Six months history ofcervical lymphadenopathy (biopsy pending)ESR 80 mm/hrHepatosplenomegalyMarrow: normal

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.00.350.35

4.34.3

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

50%50%

40%40%

Platelets

MPVPlateletcrit

140,00140,0000

880.11%0.11%

Case 16FATMA

48 Years

Six months history ofcervical lymphadenopathy (biopsy pending)ESR 80 mm/hrHepatosplenomegalyMarrow: normal

? Lymphoma

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.00.350.35

4.34.3

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

160160

95%95%

Platelets

MPVPlateletcrit

140.00140.0000

cervical lymphadenopathyESR 80 mm/hrHepatosplenomegalyMarrow: 80% mature lymphocytes

Case 17ABDULLAH68 Years

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.00.350.35

4.34.3

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

160160

95%95%

Platelets

MPVPlateletcrit

140.00140.0000

cervical lymphadenopathyESR 80 mm/hrHepatosplenomegalyMarrow: 80% mature lymphocytes

Case 17ABDULLA

H68 Years

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

21.021.0

0.640.64

7.27.2

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

50%50%

20%20%

8%8%Platelets

MPVPlateletcrit

800,00800,0000

0.8%0.8%

Case 18ZHARA

60 Years

PlethoricHeadacheRetinal vein thrombosisHot bath induced pruritisProlonged Bleeding Time

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

21.021.0

0.640.64

7.27.2

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

50%50%

20%20%

8%8%Platelets

MPVPlateletcrit

800,00800,0000

0.8%0.8%

Case 18ZHARA

60 Years

PlethoricHeadacheRetinal vein thrombosisHot bath induced pruritisProlonged Bleeding Time

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.260.26

3.23.2

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

60%60%

35%35%

Platelets

MPVPlateletcrit

350,00350,0000

880.28%0.28%

Case 19Bel Gasim

6 Years

Mild JaundiceDark Urine

Rapid drop of HbMarked polychromasiaNegative Coomb’sReceived malaria prophylaxis before a family trip to red sea

Heinz Bodies

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.260.26

3.23.2

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

60%60%

35%35%

Platelets

MPVPlateletcrit

350,00350,0000

880.28%0.28%

Case 19Bel Gasim

6 Years

Mild JaundiceDark Urine

Rapid drop of HbMarked polychromasiaNegative Coomb’sReceived malaria prophylaxis before a family trip to red sea

G6PDH Deficiency

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

4.04.00.120.12

1.251.25

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

50%50%

45%45%

Platelets

MPVPlateletcrit

8,0008,000

660.000.0055

Case 20AYED

14 Years

FeverPallorBleedingAcellular marrow

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

4.04.00.120.12

1.251.25

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

50%50%

45%45%

Platelets

MPVPlateletcrit

8,0008,000

660.000.0055

Case 20AYED

14 Years

FeverPallorBleedingAcellular marrow

APLASTIC ANEMIA

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.230.23

2.92.9

0.20.2

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

8.08.0

68%68%

30%30%

10%10%

Platelets

MPVPlateletcrit

320,00320,0000

770.22%0.22%

Case 21OMAR

28 Years

Rheumatoid arthritisESR 85 mm/hrLow Serum iron & TIBCNo response to iron

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.08.00.230.23

2.92.9

0.20.2

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

8.08.0

68%68%

30%30%

10%10%

Platelets

MPVPlateletcrit

320,00320,0000

770.22%0.22%

Case 21OMAR

28 Years

Rheumatoid arthritisESR 85 mm/hrLow Serum iron & TIBCNo response to iron

“Anemia of Chronic Disorders”

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.58.50.280.28

2.92.9

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

13%13%

80%80%

Platelets

MPVPlateletcrit

20,0020,0000

550.01%0.01%

Case 22KHALID

30 Years

FeverPallorLymphadenopathyGum hypertrophyMarrow & Blood are full of Blasts positive for non-specific esterase

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

8.58.50.280.28

2.92.9

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

13%13%

80%80%

Platelets

MPVPlateletcrit

20,0020,0000

550.01%0.01%

Case 22KHALID

30 Years

FeverPallorLymphadenopathyGum hypertrophyMarrow & Blood are full of Blasts positive for non-specific esterase

“M5”

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

12.012.00.400.40

4.54.5

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

55%55%

40%40%

Platelets

MPVPlateletcrit

180,00180,0000

770.12%0.12%

Case 23MOH’D5 Years

Black SaudiMaxillary Bone swellingNormal marrow & smear

Lesion biopsy: starry-skyLymphoproliferativedisease

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

12.012.00.400.40

4.54.5

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

55%55%

40%40%

Platelets

MPVPlateletcrit

180,00180,0000

770.12%0.12%

Case 23MOH’D5 Years

Black SaudiMaxillary Bone swellingNormal marrow & smear

Lesion biopsy: starry-skyLymphoproliferativedisease

Burkitt’s

Lymphoma

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.00.340.34

3.83.8

1.21.2

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

8.08.0

60%60%

35%35%

Platelets

MPVPlateletcrit

150,00150,0000

0.1%0.1%

Case 24JOAN

60 Years

HeadacheBlurred vision

Marrow: Full of Lymphocytes, LPC & Plasma CellsSmear: RouleauxIgM = 10 gm/L

No osteolytic lesionsR/ EPO

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

11.011.00.340.34

3.83.8

1.21.2

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

8.08.0

60%60%

35%35%

Platelets

MPVPlateletcrit

150,00150,0000

0.1%0.1%

Case 24JOAN

60 Years

HeadacheBlurred vision

Marrow: Full of Lymphocytes, LPC & Plasma CellsSmear: RouleauxIgM = 10 gm/L

No osteolytic lesionsR/ EPO Waldenstrom’s

Macroglobulinemia

THANK YOU

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

Platelets

MPVPlateletcrit

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

Platelets

MPVPlateletcrit

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

Platelets

MPVPlateletcrit

Hb. Hb. g/dLg/dL

Hct.Hct.

RCCRCC

MCV MCV fLfL

MCH MCH pgpg

MCHC MCHC g/dLg/dL

Retic. Retic. %%

RDW %RDW %

MonocytesMonocytes

BasophilsBasophils

Blasts:Blasts:

Platelets

MPVPlateletcrit

Flow CytometryFlow Cytometry

NORMAL BLOOD VALUES. SHEIKHA NORMAL HEMATOLOGICAL VALUES.

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