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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 hemato-poietic 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 - 3.0Ч1012/L.

MCH - to be calculated.

Reticulocytes - 0.6%.

Platelets - 105Ч109/L.

Leukocytes (total) - 36Ч109/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 anti-RBC and antiplatelet antibodies are found in the blood.

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