Acute lymphoblastic leukaemia Case No. 7 (Pathology)

In this post, we try to understand the concept of Acute lymphoblastic leukaemia diagnosis. A history or scenario is given you should read it carefully and then try to understand it. Pathology egg website is made for medical students where they can get helping material easily. Now let’s move to our case study no. 7

 

Acute lymphoblastic leukaemia Case Scenario

A 4-year-old male child is brought by the mother to the paediatrician with a low temperature, headache and nosebleed. Upon examination, it is found that the child has mild hepatosplenomegaly but no lymphadenopathy. A routine complete blood count (CBC) shows hemoglobin 6 g / dL, white blood cell count 80,000 / μl, and platelet count 40,000 / μl.

Requirements:

1. Discuss the clinical correlation with the pathogenesis of the features.

2. What is the probable diagnosis?

3. How will you investigate and confirm the diagnosis?

Clinical Correlation

The child has several symptoms suggestive of acute leukaemia – fairly high TLC, low platelet count with thrombocytopenic bleeding from the nose, moderate anaemia, and mild organomegaly. A mild fever is a common feature of acute leukaemia, along with other features just described. Organomegaly is due to the infiltration of the liver and spleen by leukemic cells. The most common form of acute leukaemia in children is ALL.

 

Probable Diagnosis

Acute lymphoblastic leukaemia

 

Investigations:

Here is how you can investigate Acute lymphoblastic leukaemia through Clinical pathology

  1. CBC (haemoglobin, counts, indices), ESR, PCV, blood smear for type of anaemia.
  2. Urine examination (albumin, glucose, microscopy).
  3. Biochemical estimation: Renal function tests (urea, creatinine, BUN), liver function tests (bilirubin, ALT, AST, alkaline phosphatase, total proteins and AG ratio).
  4. X-ray chest.
  5. Ultrasound examination of the abdomen.

Additional tests

You can perform the additional tests in order to diagnose Acute lymphoblastic leukaemia case no. 7

  1. Bone marrow examination along with cytochemistry. i
  2. Immunophenotyping. i
  3. Cytogenetic studies.

Reference: Harsh Mohan Pathology

 

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