May 97
Case
Easy bruisability, gum and nose bleeding in a 25 year old man
History
- A 25 year old white man complained of a 3-4 week history of easy bruising.This was eventually followed by bleeding from his gums on brushing histeeth and occasional nose bleeds. He denied any vomiting, shortness ofbreath, chest pain, fever, chills or weight loss. He was painting his housefor a period of 3 weeks in the last 2 months. His past medical historyis unremarkable. He does not smoke or abuse alcohol.
Physical
Examination
- He appeared to be in no acute distress. Blood pressure 138/90 mmHg,Respiration 18/min, Pulse 61/min, Temperature 37.3oC. His skin showed ecchymosesover the right calf area. HEENT revealed some bleeding around the gum areabut no hypertrophy. There was no palpable lymphadenopathy. Chest and lungexamination was clear. Cardiovascular exam was unremarkable. Abdomen hadno organomegaly. Neurologic examination was normal.
Laboratory
Data
Test | Value | Test | Value | Test | Value |
|---|---|---|---|---|---|
Radiologic
Examinations
- Chest radiograph: No active disease.
Other Special
Tests
- Bone Marrow cytogenetics: 46, XY, t(15;17)(q22;q11)
Flow cytometry of bone marrow cells:
CD1a (0%), CD2 (55.4%), CD3(0.2%), CD4 (2.8%), CD5(0.9%),CD7(0.3%),CD8(0.1%),CD10(0.2%), CD19(0.2%), CD20(1.0%), CD13(4.1%), CD15(32.2%), CD33(98.7%),HLA-DR(0.6%), CD45(91.6%)
Microscopic
Slides
- Peripheral Blood Smears:
Oilimmersion x500
Oilimmersion x1000
Bone marrow aspirate:
Oilimmersion x500
Oilimmersion x1000
Oilimmersion x1000
Oilimmersion myeloperoxidase stain x1000