Question

A 57-year-old truck driver presents for evaluation of chest pain and dyspnea on minimal exertion. The patient reports gradually worsening generalized fatigue over the preceding 3 months. The physical examination reveals splenomegaly. The CBC with differential revealed the following: Test Result WBC 23.5 RBC 2.9 HGB 8.8 HCT 25.2 MCV 87.3 MCH 30.3 MCHC 34.9 PLT 463 RDW 17.0 MPV 9.2 The differential showed 30% neutrophils, 2% lymphocytes, 1% monocytes, 7% eosinophils, 10% basophils, 18% metamyelocytes, 28% myelocytes, and 4% blasts. What is the differential diagnosis? What is the patient’s most likely diagnosis? What tests can you use to confirm the diagnosis? What results would you expect? How do you treat this condition?

          A 57-year-old truck driver presents for evaluation of chest pain and dyspnea on minimal exertion. The patient reports gradually worsening generalized fatigue over the preceding 3 months. The physical examination reveals splenomegaly. The CBC with differential revealed the following: Test Result WBC 23.5 RBC 2.9 HGB 8.8 HCT 25.2 MCV 87.3 MCH 30.3 MCHC 34.9 PLT 463 RDW 17.0 MPV 9.2 The differential showed 30% neutrophils, 2% lymphocytes, 1% monocytes, 7% eosinophils, 10% basophils, 18% metamyelocytes, 28% myelocytes, and 4% blasts. What is the differential diagnosis? What is the patient’s most likely diagnosis? What tests can you use to confirm the diagnosis? What results would you expect? How do you treat this condition?

Added by Michelle V.

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