Chart-10

A 40 year old lady complains of dragging sensation in the left hypochondrium. 

On examination: marked splenomegaly present 

Laboratory findings: 

 Hemoglobin                         10 gm/dl

Total leucocyte count         1.8 lakhs/cumm 

Platelet count                      3.1 lakhs /cumm 

Peripheral blood smear

A. Interpret the WBC findings in peripheral smear. What is your diagnosis? 

WBCs are markedly increased in number and show myeloid series of cells with shift to left consisting of neutrophils, band forms, metamyelocytes, myelocytes,promyelocytes and blasts. Basophilia seen 

Diagnosis: Chronic Myeloid Leukemia 

B. What chromosomal abnormality is frequently seen in this condition? 

95% of patients demonstrate Philadelphia chromosome which is the reciprocal translocation between chromosome 9 and 22 [rt (9;22)] 

C. What is Leukemoid reaction? 

It is a reactive leucocytosis seen in few infections. WBCs are moderately increased in number and show myeloid series of cells with shift to left consisting of neutrophils, band forms, metamyelocytes, myelocytes and promyelocytes. Blasts are rare and lack basophilia.