What is the most likely diagnosis? And why? Use the bone marrow biopsy and the CBC results included to justify the answer. -Justify the diagnosis using the morphology of the cells listed in CBC section. Compare it with the reference ranges.

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Chapter12: Surgical Case Management
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Look at the attached image. What is the most likely diagnosis? And why? Use the bone marrow biopsy and the CBC results included to justify the answer. -Justify the diagnosis using the morphology of the cells listed in CBC section. Compare it with the reference ranges.
History:
51 year old male, general health reported as OK, good diet perhaps a little loss of
appetite, regular exercise a little fatigued usually explained by 'over doing it at the gym'.
Patient was seen by his GP for a routine preoperative check before dental surgery. He was
found to have low haemoglobin and large left upper quadrant mass.
Complete blood count (CBC):
3.36 x 1012/L
9.3 x 10/L
5.9 x 10°/L
RBC
WBC
PLT
HGB
10.9
g/dL
HCT
31.2
MCV
92.8
fL
Neutrophils
Lymphocytes
Abnormal cells
14%
15%
71% (shown)
Further Laboratory Studies
Bone marrow biopsy:
Aspirate: A small
abnormal cells similar to those in the blood smear.
unt of fluid was aspirated, and showed 78.1%
Sections: Hypocellular with a diffuse loosely structured infiltrate of
mononuclear cells. Increased areas of fibrosis.
Cytochemistry: Tartrate resistant acid phosphatase (TRAP) stain of
abnormal cells: positive
Transcribed Image Text:History: 51 year old male, general health reported as OK, good diet perhaps a little loss of appetite, regular exercise a little fatigued usually explained by 'over doing it at the gym'. Patient was seen by his GP for a routine preoperative check before dental surgery. He was found to have low haemoglobin and large left upper quadrant mass. Complete blood count (CBC): 3.36 x 1012/L 9.3 x 10/L 5.9 x 10°/L RBC WBC PLT HGB 10.9 g/dL HCT 31.2 MCV 92.8 fL Neutrophils Lymphocytes Abnormal cells 14% 15% 71% (shown) Further Laboratory Studies Bone marrow biopsy: Aspirate: A small abnormal cells similar to those in the blood smear. unt of fluid was aspirated, and showed 78.1% Sections: Hypocellular with a diffuse loosely structured infiltrate of mononuclear cells. Increased areas of fibrosis. Cytochemistry: Tartrate resistant acid phosphatase (TRAP) stain of abnormal cells: positive
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