Mike Leach - Haematology: From the Image to the Diagnosis

Mike Leach MB ChB, FRCP, FRCPath

Consultant Haematologist and Honorary Senior Lecturer
Haematology Laboratories and West of Scotland Cancer Centre
Gartnavel General Hospital, Glasgow, UK

Barbara J. Bain MB BS, FRACP, FRCPath

Professor of Diagnostic Haematology
St Marys Hospital Campus, Imperial College London
and Honorary Consultant Haematologist
St Marys Hospital, London, UK

There is always more to learn the study of haematology is a constant journey, not a destination

This edition first published 2022
2022 John Wiley & Sons Ltd

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.

The right of Mike Leach and Barbara J. Bain to be identified as the authors of this work has been asserted in accordance with law.

Registered Offices
John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USA
John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial Office
9600 Garsington Road, Oxford, OX4 2DQ, UK

For details of our global editorial offices, customer services, and more information about Wiley products visit us at www.wiley.com.

Wiley also publishes its books in a variety of electronic formats and by printondemand. Some content that appears in standard print versions of this book may not be available in other formats.

Limit of Liability/Disclaimer of Warranty
The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Library of Congress CataloginginPublication Data

Names: Leach, Richard M. (Haematologist), author. | Bain, Barbara J., author.
Title: Haematology : from the image to the diagnosis / Mike Leach, Barbara J. Bain.
Description: Hoboken, NJ : WileyBlackwell, 2022. | Includes bibliographical references and index.
Identifiers: LCCN 2021010953 (print) | LCCN 2021010954 (ebook) | ISBN 9781119777502 (hardback) | ISBN 9781119777519 (adobe pdf) | ISBN 9781119777526 (epub)
Subjects: MESH: Hematologic Diseasesdiagnosis | Blood Physiological Phenomena | Examination Questions | Case Reports
Classification: LCC RC636 (print) | LCC RC636 (ebook) | NLM WH 18.2 | DDC 616.1/5dc23
LC record available at https://lccn.loc.gov/2021010953
LC ebook record available at https://lccn.loc.gov/2021010954

Cover Design: Wiley
Cover Image: Mike Leach

Despite the tremendous advances that have occurred in diagnostic haematopathology in recent decades, haematology remains firmly based on a clinical assessment of the patient, on basic laboratory tests and on a critical assessment of peripheral blood and bone marrow films. In this book we seek to show how an appreciation of blood and bone marrow morphology, assessed with knowledge of the clinical context, can lead to a provisional or, sometimes, a definitive diagnosis that guides further investigation and management. Each of the 101 themes is followed by a related multiple choice question with the preferred answers and further discussion being found in the second part of the book. The multiple choice questions can have more than one true answer. The themes are sometimes single cases and sometimes a composite of related cases. The book is directed at consultants and trainees in haematology and haematopathology and at clinical and biomedical scientists in these disciplines. We hope that readers will share our enjoyment of the constant sense of discovery that accompanies haematological morphology.

All magnifications are stated in terms of the objective used. Common abbreviations that may be used without definition are given on page xi. Other abbreviations are defined on first use in a theme. All images are of films stained with a MayGrnwaldGiemsa stain unless stated otherwise. The cases are not arranged thematically, since a more random arrangement better approximates to real life.

We wish to thank our clinical and laboratory colleagues with whom we have collaborated over many years.

Mike Leach and Barbara Bain, January 2021

WBCwhite blood cell countRBCred blood cell countHbhaemoglobin concentrationHcthaematocritMCVmean cell volumeMCHmean cell haemoglobinMCHCmean cell haemoglobin concentration AAaplastic anaemiaALacute leukaemiaALKanaplastic lymphoma kinaseALLacute lymphoblastic leukaemiaALPalkaline phosphataseALTalanine transaminaseAMLacute myeloid leukaemiaANAantinuclear antibodyAPLacute promyelocytic leukaemiaAPTTactivated partial thromboplastin timeASTaspartate transaminaseATLLadult Tcell leukaemia/lymphomaBLBurkitt lymphomaccytoplasmicCDcluster of differentiationCHOPcyclophosphamide, doxorubicin, vincristine and prednisoloneCLLchronic lymphocytic leukaemiaCMLchronic myeloid leukaemiaCMMLchronic myelomonocytic leukaemiaCNScentral nervous systemCRPCreactive proteinCSFcerebrospinal fluidCTcomputed tomographyDICdisseminated intravascular coagulationDLBCLdiffuse large Bcell lymphomaDNAdeoxyribonucleic acidEBVEpsteinBarr virusESRerythrocyte sedimentation rateETessential thrombocythaemiaFISHfluorescenceNext page