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17. MALIGNANCIES OF HEMATOPOIETIC CELLS (HEMOBLASTOSIS)

Questions to prepare for classes and examination

•  Typical features, types, etiology, and general pathogenesis of hematopoietic cell tumors.

•  Leukemia: general characteristics, causes, classification and mechanisms of development.

•  Characteristics of leukemic reaction of the peripheral blood; types of leukemic reaction.

•  Lymphoid tumors: pathological basis, clinical manifestations, and peripheral blood picture in the acute lymphoblastic leukemia and chronic lymphocytic leukemia.

•  Myeloid tumors: classification, pathological basis, clinical manifestations, and the peripheral blood picture in the acute myeloblastic leukemia and chronic myelogenous leukemia.

•  Phenomenon of tumor progression in hematopoietic cell tumors.

N 78

A 62-year-old female patient has been hospitalized with the diagnosis of exacerbation of chronic bronchopneumonia. The patient complains of weakness, dyspnea, fever. On examination: the patient is pale; she has a tint of jaundice in the conjunctiva, and a moderate enlargement of the regional lymph nodes, spleen, and liver. An X-ray examination reveals the signs of right-sided bronchopneumonia, a significant enlargement of the hilar lymph nodes. Complete blood counts with differential shows:

Hb - 80 g/L.

Erythrocytes - 3.0x1012/L. MCH - to be calculated. Reticulocytes - 0.6%. Platelets - 105x109/L. Leukocytes (total) - 36x109/L.

Myelocytes - 0. Metamyelocytes - 0. Band neutrophils - 0.5%. Segmented neutrophils - 6.0%. Basophils - 0. Eosinophils - 0. Lymphoblasts - 1.5%. Lymphocytes - 89.5%. Monocytes - 2.5%.

An increased content of unconjugated bilirubin, and the presence of antiRBC and antiplatelet antibodies are found in the blood.

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