Abdulaziz (Omar) Badran: A Reminder That Morphology Still Matters in Modern Hematology
Abdulaziz (Omar) Badran, Hematology Supervisor at Almoosa Specialist Hospital, shared a post on LinkedIn:
”Good evening to all, our case today is little challenging, it’s for 85 years lady came to ER and her CBC shows marked critical WBCs with 154 and low HGB with marked Thrombocytopenia.
After confirming the counts we directly prepared slide to confirm and here was the surprise.
The scatters for WBCs show multi zones for lymphocytes and these populations are variant in size and complexity.
The slide shows disaster forms of lymphocytes in all shapes; reactive, blasts like, plasma cells and lymphoma cells like. Then I checked her file after they enter in ER to find that she was diagnosed out side with Lymphoma. There is no subtype, so am not sure if she came to our hospital for double check or for treatment or what. We will wait to see if they will do bone marrow for diagnosis or they will begin with treatment plan, God be with her.
Lymphoma is a type of blood cancer that develops when infection-fighting white blood cells, called lymphocytes, grow uncontrollably. These abnormal cells multiply and build up in the lymphatic system-which includes the lymph nodes, spleen, and thymus—often forming tumors.
Lymphoma is categorized into over 70 subtypes, but it falls into two primary groups:
- Hodgkin Lymphoma: Distinguished by the presence of a specific, abnormally large cell called a Reed-Sternberg cell.
- Non-Hodgkin Lymphoma: Includes all other types of lymphoma. This category is much more common and is further broken down into slow-growing (indolent) and fast-growing (aggressive) forms.
lymphoma cases can absolutely contain plasma cells, blast-like cells, or both simultaneously.
In hematopathology, the presence of these cell types depends heavily on the specific lymphoma subtype, its level of cellular differentiation, and whether the cancer has transformed into a more aggressive state.
She was admitted to ICU under observation and I will see tomorrow morning what’s the decision for our doctors here and wish all the best for this old lady, and God bless you all.”
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