A Case with Pancytopenia: The Role of Cytomorphology

A 63-year year old lady presented with prolonged fever, frequent abdominal pain and a history of melena. Physical findings revealed an anemic appearance and splenomegaly. She was treated by the gastroenterologist and subsequently referred to the hematologist as the peripheral blood count revealed p...

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Main Authors: Lugyanti Sukrisman, Nadia A Mulansari, Aru W Sudoyo
Format: Article
Language:English
Published: Interna Publishing 2013-01-01
Series:Acta Medica Indonesiana
Online Access:http://actamedindones.org/index.php/ijim/article/view/124
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author Lugyanti Sukrisman
Nadia A Mulansari
Aru W Sudoyo
author_facet Lugyanti Sukrisman
Nadia A Mulansari
Aru W Sudoyo
author_sort Lugyanti Sukrisman
collection DOAJ
description A 63-year year old lady presented with prolonged fever, frequent abdominal pain and a history of melena. Physical findings revealed an anemic appearance and splenomegaly. She was treated by the gastroenterologist and subsequently referred to the hematologist as the peripheral blood count revealed pancytopenia with a hemoglobin level of 6.5 g/dl, WBC 4000/ uL and a platelet count of 50.000 /uL. No blast cells were found. Patient subsequently underwent a marrow aspiration. Cytomorphology assessment of the marrow specimen revealed the presence of abnormal megakaryocytes and leukocytes (see figures) which was in accordance with dyshematopeosis, and the diagnosis of MDS (myelodysplatic syndrome) was established. The patient was then started on thalidomide 100 mg daily. There was no significant complications nor side-effects and after almost 2 years her hemoglobin level is now normal (between 12 and 14 g/dl), a dramatic reversal of her condition.
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publishDate 2013-01-01
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series Acta Medica Indonesiana
spelling doaj-art-e5f2420eba4d4fc88ba622012bf51c342025-08-20T04:00:28ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322013-01-01451A Case with Pancytopenia: The Role of CytomorphologyLugyanti Sukrisman0Nadia A Mulansari1Aru W Sudoyo2Department of Internal Medicine, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo HospitalDepartment of Internal Medicine, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo HospitalDepartment of Internal Medicine, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo Hospital A 63-year year old lady presented with prolonged fever, frequent abdominal pain and a history of melena. Physical findings revealed an anemic appearance and splenomegaly. She was treated by the gastroenterologist and subsequently referred to the hematologist as the peripheral blood count revealed pancytopenia with a hemoglobin level of 6.5 g/dl, WBC 4000/ uL and a platelet count of 50.000 /uL. No blast cells were found. Patient subsequently underwent a marrow aspiration. Cytomorphology assessment of the marrow specimen revealed the presence of abnormal megakaryocytes and leukocytes (see figures) which was in accordance with dyshematopeosis, and the diagnosis of MDS (myelodysplatic syndrome) was established. The patient was then started on thalidomide 100 mg daily. There was no significant complications nor side-effects and after almost 2 years her hemoglobin level is now normal (between 12 and 14 g/dl), a dramatic reversal of her condition. http://actamedindones.org/index.php/ijim/article/view/124
spellingShingle Lugyanti Sukrisman
Nadia A Mulansari
Aru W Sudoyo
A Case with Pancytopenia: The Role of Cytomorphology
Acta Medica Indonesiana
title A Case with Pancytopenia: The Role of Cytomorphology
title_full A Case with Pancytopenia: The Role of Cytomorphology
title_fullStr A Case with Pancytopenia: The Role of Cytomorphology
title_full_unstemmed A Case with Pancytopenia: The Role of Cytomorphology
title_short A Case with Pancytopenia: The Role of Cytomorphology
title_sort case with pancytopenia the role of cytomorphology
url http://actamedindones.org/index.php/ijim/article/view/124
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