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Unexpected aetiology of chronic thrombocytopaenia
  1. Todd Needs,
  2. David Lynch
  1. US Army Brooke Army Medical Center, Fort Sam Houston, Texas, USA
  1. Correspondence to Dr Todd Needs, US Army Brooke Army Medical Center, San Antonio, TX 78219, USA; needs2024{at}gmail.com

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Clinical question

An asymptomatic adult woman with no significant medical or family history was found to have splenomegaly during workup for chronic, mild thrombocytopaenia. A peripheral blood smear showed isolated thrombocytopaenia and was otherwise unremarkable. A bone marrow aspirate was essentially a dry-tap with normal flow cytometry and cytogenetics. Touch preparations and histological sections of the core biopsy demonstrated abundant histiocytes (figure 1). The background trilineage haematopoiesis was otherwise unremarkable.

Figure 1

Bone marrow aspirate and core biopsy. Histiocytes with characteristic ‘Gaucher cell’ features on touch preparations (A,B). Wright-Giemsa. Histological sections demonstrate diffuse infiltration of the bone marrow by histiocytes (C). High magnification shows bland histiocytes with voluminous cytoplasm with a lightly eosinophilic, striated appearance (D). H&E (C,D).

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Footnotes

  • Handling editor Iskander Chaudhry.

  • Contributors The manuscript and figures were prepared and reviewed by both listed authors with institutional approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Air Force, the Department of the Army or the Department of Defense or the U.S. Government.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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