T cell lymphoma

Patient Data: seen on 14-9-1436

59 years/F/Nigerian.
Repeated blood Tf: Hb was 2.4
CBC & pbs
WBC: 8.5
Hb: 5.5
plt: 293.000
dimorphic picture.
mild left shift.
Occasional atyp L.
Coombs test +ve
direct and indirect.
LDH: 1519.
On methyl prednisolone
125 mg IV BID.
BM asp report :
It is aparticulated and hemodiluted BM asp,
no particles are seen. Megakaryocytes are
not seen (?dilutional effect).
The trails show good number of cells.
Erythropoiesis is active and normoblastic.
Granulopoiesis is active and shows normal
sequence of maturation. M :E ratio 7:1 .
Blasts are less than 1% of all nucleated
marrow cells. Many degenerated cells
are seen. No abnormal cells are seen.
Iron stain is not available.

BM bx report :
Hypercellular bone marrow biopsy.
There is focal and interstitial infiltration
by pleomorphic cells. They are of large and
intermediate size, hyperchromatic nuclei
with variable prominent nucleoli. They are
positive for CD45, CD4,
Ki67(proliferative activity) while show negative
reaction for myeloid antigens(MPO, CD34)
and B cell markers(CD19, CD20).
Reticulin fibers are increased in thickness
and density(+3)

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