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B cell chronic lymphocytic leukemia (CLL) also called chronic lymphocytic leukemia is a disease of elderly, but in rare cases it can occur in young adults. Majority of patients present with no specific symptoms, and CLL is suspected on the basis of high total and relative lymphocyte counts, discovered on routine blood examination. This patient was referred from medicine outpatient in our institute, Era's Lucknow Medical College & Hospital for routine complete blood count. His total leukocyte count came out to be alarmingly high. The general blood picture and bone marrow examinations were consistent with CLL. On immunophenotyping CD5 and CD23 were positive. His cervical lymph nodes biopsy was reported as a case of CLL/small lymphocytic lymphoma. On his complaint of hazy vision his funduscopy revealed maculopathy. This makes our case a unique and rare one, as maculopathy in a young patient of CLL has not yet been reported from India.
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BACKGROUND AND OBJECTIVES: Riyadh and central province falls in a moderate prevalent zone of hemoglobinopathies in Saudi Arabia. However, it has been observed that the physicians working in Saudi Arabia invariably advise all cases of anemia for hemoglobin electrophoresis (HE). The present work was carried out to study the yield of the HE in Riyadh and the investigative practices of the physicians advising HE. SETTINGS AND DESIGN: The study was carried out in the hospitals of King Saud University from 2009 to 2011 in order to assess the yield of HE in referred cases of clinical anemia. MATERIALS AND METHODS: A total of 1073 cases divided in two groups of males and females had undergone complete blood count and red blood cell morphology. Cellulose acetate HE was performed and all the positive results were reconfirmed on the high performance liquid chromatography (HPLC). The results were analyzed for the type of hemoglobinopathies. For statistical analysis Statistical Package for Social Sciences 15 version (SPSS Inc., Chicago, IL, USA) was used. RESULTS: A total of 405 males and 668 females blood samples were included in the present study. 116 (28.5%) males and 167 (25%) females showed an abnormal pattern on HE. The incidence of beta thalassemia trait was higher in females while sickle cell trait was predominantly seen in males. Red cell indices were reduced considerably in thalassemias, but were unaffected in sickle cell disorders, except those which had concurrent alpha trait. The total yield of HE was 26.6% which was much less than expected. CONCLUSION: The physicians are advised to rule out iron deficiency and other common causes of anemia before investigating the cases for hemoglobinopathies, which employs time consuming and expensive tests of HE and HPLC.
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The metastasis of bone marrow by the solid tumors is a sign of advanced stage of disease and poor prognosis. The aim of this study was to assess the pattern of bone marrow involvement of different solid tumors and their correlation with hematological findings. In a retrospective study we evaluated 434 aspirates and 76 biopsy sections from 124 cases of different types of solid tumors previously diagnosed on the basis of their clinical and histopathological findings. The hematological profile of the patients was done and correlated with the bone marrow findings. The study was carried out at a medical college hospital of northern India. Out of 124 cases of solid tumors 31 (25%) have metastasized to bone marrow. The highest number 25 (36%) of bone marrow involvement was seen in carcinoma prostate followed by gastric carcinoma and melanoma (25%) The least number (14.2%) cases of bone marrow metastasis were observed in endometrial carcinoma. Anemia was found the commonest (71.4%) hematological finding followed by thrombocytopenia in 45.1% cases. The bone marrow examination is an easy, convenient, sensitive and cost effective procedure for assessment of staging and monitoring of prognosis of solid tumors.
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BACKGROUND AND AIMS: Saudi Arabia falls in the high prevalent zone of αα and ß thalassemias. Early screening for the type of thalassemia is essential for further investigations and management. The study was carried out to differentiate the type of thalassemia based on red cell indices and other hematological parameters. MATERIALS AND METHODS: The study was carried out on 991 clinically suspected cases of thalassemias in Riyadh, Saudi Arabia. The hematological parameters were studied on Coulter STKS. Cellulose acetate hemoglobin electrophoresis and high-performance liquid chromatography (HPLC) were performed on all the blood samples. Gene deletion studies were carried out by restriction fragment length polymorphism (RFLP) technique using the restriction endonucleases Bam HI. STATISTICAL ANALYSIS: Statistical analysis was performed on SPSS 11.5 version. RESULTS: The hemoglobin electrophoresis and gene studies revealed that there were 406 (40.96%) and 59 (5.95 %) cases of ß thalassemia trait and ß thalassemia major respectively including adults and children. 426 cases of various deletion forms of α thalassemias were seen. Microcytosis was a common feature in ß thalassemias trait and (-α/-α) and (--/αα) types of α thalassemias. MCH was a more significant distinguishing feature among thalassemias. ß thalassemia major and α thalassemia (-α/αα) had almost normal hematological parameters. CONCLUSION: MCV and RBC counts are not statistically significant features for discriminating between α and ß thalassemias. There is need for development of a discrimination index to differentiate between α and ß thalassemias traits on the lines of discriminatory Indices available for distinguishing ß thalassemias trait from iron deficiency anemia.
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We followed 565 male patients with non-Hodgkin's lymphoma (NHL) in two hospitals of Saudi Arabia. We investigated these cases for presence of hepatitis B virus (HBV) and hepatitis C virus (HCV) by determining the HBsAg and anti-HCV. Anti-HCV positive cases were confirmed by PCR. The NHL cases were classified on the basis of working formulation. The results of HBV and HCV in cases of NHL were compared with the prevalence of these viruses in healthy male blood donors. We found 11.2% of cases of NHL were positive for HBV and 16.1% for HCV, compared to 3.4% HBV and 2.9% HCV among blood donors. The highest numbers of cases (48.4% of HBV and 56% of HCV) were seen in the intermediate and low grade of NHL, respectively. Follicular small cleaved was the predominant type in both types of infection. The variation in prevalence of HBV and HCV in NHL from that of the general population was statistically significant (p<0.001). We observed that the background prevalence of HBV definitely affects the rate of infection in NHL, while infection of HCV in cases of NHL is independent of its background prevalence.
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Multiple parameters are needed to diagnose thyroid disorders. 100 cases of thyroid swellings were studied by clinical assessment, hormonal assay, fine needle aspiration cytology (FNAC), antithyroglobulin (Tg) and antimicrosomal (Tm) antibodies and histopathology. The cases were divided into four groups. Cases of thyroiditis on FNAC showed predominance of lymphocytes (76%), hurthle cells (77%), epithelioid cells and giant cells (31%) and high titres of Tg (66%) and Tm (92%). Non toxic goitre was characterized by colloid and foam cells (100%) and low positivity for Tg and Tm (25%). Toxic goitre showed colloid (30%). Hurthle cells, anisonucleosis of acinar cells (38%), fire flare (62%) and high positivity for Tg and Tm (73%). Neoplasia was diagnosed mainly by cell morphology on FNAC and a low positivity for Tg and Tm (30%). FNAC in correlation with thyroid antibodies is useful in diagnosing autoimmune thyroiditis, goitre, Grave's disease and malignancy of thyroid. Antibodies have a specific role in the diagnosis of early stage of thyroiditis.
