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IMAGE QUIZ
Year : 2019  |  Volume : 7  |  Issue : 1  |  Page : 55-59

Splenomegaly and pancytopenia in an elderly male


1 Department of Pathology, Hematopathology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
2 Department of Internal Medicine, Hematology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

Date of Web Publication14-Dec-2018

Correspondence Address:
Dr. Abrar J Alwaheed
Department of Internal Medicine, Hematology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam
Saudi Arabia
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DOI: 10.4103/sjmms.sjmms_234_18

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How to cite this article:
Aldossary NJ, Alwaheed AJ. Splenomegaly and pancytopenia in an elderly male. Saudi J Med Med Sci 2019;7:55-9

How to cite this URL:
Aldossary NJ, Alwaheed AJ. Splenomegaly and pancytopenia in an elderly male. Saudi J Med Med Sci [serial online] 2019 [cited 2019 Jan 20];7:55-9. Available from: http://www.sjmms.net/text.asp?2019/7/1/55/247520



A 62-year-old male presented with generalized weakness and abdominal discomfort since the past 4 months; there were no other significant complaints. On examination, the patient was pale and his abdominal palpitation revealed an enlarged, firm, nontender splenomegaly 10-cm below the costal margin. His complete blood count results were as follows: white blood cell (WBC) count, 3.0 × 109/L; red blood cell count, 2.37 × 1012/L; hemoglobin, 6.7 g/dl; and platelet count, 30 × 109/L. A peripheral blood smear demonstrated normocytic normochromic red cells with a WBC differential count of 22% polymorphs, 70% lymphocytes, 2% monocytes, 1% eosinophils and 5% atypical cells [Figure 1]a and [Figure 1]b. Bone marrow aspiration was not possible (“dry tap”). The hematoxylin and eosin staining of the trephine bone marrow biopsy showed an infiltration by cells with a characteristic “fried egg” appearance of the cytoplasm [Figure 2].
Figure 1: (a and b) Peripheral blood smear showing an atypical cell with multiple cytoplasmic projections

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Figure 2: Hematoxylin and eosin staining of the bone marrow biopsy

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  Questions Top


  1. What are the atypical cells seen in [Figure 1]?
  2. What are the confirmatory tests and what is the final diagnosis?




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