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Forum Name: Hematology Topics

Question: Blood Smear Abnormal Answer Please


 mammer46 - Mon Jul 11, 2005 5:02 am

Dear Doctor,
I am a 48 yr. old female. I recently was @ my GP and he did a routine CBC. I had been having heart palpitations along with excessive fatigue, in general feeling just plain lousy.
The CBC came back with elevated WBC and he ordered an EKG which was normal.
He repeated the CBC 3 days later, then sent me to Hosp. for a Periphial blood smear.
By the way the first CBC showed a WBC of 15000, the second showed a WBC 12000 with lymphocyte of 60 %.
The blood smear came back and the WBC was 13000, with high absolute lymphocyte at 70 %.
I asked if I had an infection, he said no. When I pressed him about what the problem was he just said I have an "overactive bone marrow", and wants to repeat the blood smear in 30 days. Wants to do an abdominal CT scan, somtime this week.
Can you please tell me what the problem is with my blood smear test ?
Help me to understand. Is he suspicious of leukemia ? I looked up Lymphocytes (absolute), and mine seem to be very high.
I would really appreciate an resopnse to my post. It is really worrying me.
I am new to this site, and since I can't seem to get a DIRECT answer from my GP, hope you can help !

Thanks
Cindy
 Dr. Anthony Solomon - Mon Jul 11, 2005 7:11 am

Your CBC results are indicative of lymphocytic leucocytosis. In this condition, lymphocytes are increased as a response to any of the following causes:

viral infections,
some bacterial infections such as tuberculosis,
certain cancers such as lymphoma or acute and chronic lymphocytic leukaemia
other medical conditions such as Crohn’s or Graves’ disease.


When an increased number of lymphocytes is detected, a blood sample is examined under a microscope to determine if the lymphocytes in the bloodstream appear activated (as occurs in response to viral infections) or if they appear immature or abnormal (as occurs in certain leukemias or lymphomas).

Dr Anthony Solomon
Consultant Physician, Tropical & Genitourinary Medicine
 mammer46 - Mon Jul 11, 2005 8:33 am

Thank you Doctor for your response. Since my GP says there is no infection, am I to assume the worse ?
Would ALL or CLL explain my symptoms of severe fatigue, swollen belly and sore joints ?
Should he proceed with a bone marrow test or is he correct in waiting 30 days to repeat the Per. blood smear.

I appreciate your expert opinion.

Thank You
Cindy
 Dr. Anthony Solomon - Tue Jul 12, 2005 6:19 am

You did not mention abdominal swelling as one of your symptoms in the first post.
You must not assume the worse, because many conditions, as stated, can give a similar blood picture.
I support the idea of an abdominal CT scan if you have an abdominal swelling, and a wise decision would be to have the opinion of a haematologist for further evaluation of lymphocytic leucocytosis.

Dr Anthony Solomon

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