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- myeloproliferative disease
- bone marrow trephines
- lymph nodes
- lymph node pathology
A 41-year-old lady of Afro-Caribbean origin was referred to our unit for further investigation of pancytopenia and splenomegaly; a diagnosis of primary myelofibrosis was suspected.
Two years previously, she had been investigated in her local hospital for pancytopenia (haemoglobin 10.9 g/dl, mean cell volume (MCV) 79 fl, platelet count 111×109/l and white blood cell (WBC) 2.9×109/l). Systemic enquiry revealed that she had bony aches and pains and menorrhagia. She was known to have uterine fibroids but there was no other medical or family history of note.
Clinical examination indicated moderate splenomegaly and her spleen measured 22 cm on a CT scan. A blood film was unremarkable but testing for JAK-2V617F …
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