leukemia Q

[docnc]

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For the past 6 months,a 65yrs man has noted incresing fatigue & shortness of breath with minimal excercise.He has noted some abdominal discomfort over the past month.he has been healthy all his life.On physical exam,he has non tender cervical lymhadenopathy.A CBC shows absolute lymphocytosis(>100,00/microL) & increased (>30%) in the bone marrow.Which of the following is the most likely diagnosis?

1. CML
2. CLL
3. AML
4. ALL

ans is 2.CLL....but except for the age factor all symptoms are predominant features of CML.....plz justify the ans.....

 

[docnc]

can anybody wll hlp me 4 ths Q....plzzz

 

[uzair]

Hi,
Let's discuss the differences between CLL and CML,Why do u think CML should be the answer here?
I think CLL is the right answer cause of the age given and CLL is more common than CML.
I would reason it tht way.

The following symptoms of leukemia are common to all types:

Unexplained fevers

Frequent infections

Night sweats

Fatigue (feeling tired or washed out)

Weight loss

Easy bleeding or bruising

Collection of leukemia cells in certain parts of the body may cause the following symptoms:

Headache

Confusion

Balance problems

Blurred vision

Painful swellings in the neck, under the arms, or in the groin

Shortness of breath

Nausea or vomiting

Abdominal pain and/or swelling

Testicular pain and/or swelling

Pain in the bones or joints

Weakness or loss of muscle control

Seizures

About CML---

Most cases of CML appear to be induced by a translocation known as the Philadelphia (Ph) chromosome, which is demonstrable in 95% of patients. It is a reciprocal translocation t(9;22) in which a piece of chromosome 9 containing the oncogene c-abl is translocated to chromosome 22

 

[docnc]

Hi,
Let's discuss the differences between CLL and CML,Why do u think CML should be the answer here?
I think CLL is the right answer cause of the age given and CLL is more common than CML.
I would reason it tht way.

The following symptoms of leukemia are common to all types:

Unexplained fevers

Frequent infections

Night sweats

Fatigue (feeling tired or washed out)

Weight loss

Easy bleeding or bruising

Collection of leukemia cells in certain parts of the body may cause the following symptoms:

Headache

Confusion

Balance problems

Blurred vision

Painful swellings in the neck, under the arms, or in the groin

Shortness of breath

Nausea or vomiting

Abdominal pain and/or swelling

Testicular pain and/or swelling

Pain in the bones or joints

Weakness or loss of muscle control

Seizures

About CML---

Most cases of CML appear to be induced by a translocation known as the Philadelphia (Ph) chromosome, which is demonstrable in 95% of patients. It is a reciprocal translocation t(9;22) in which a piece of chromosome 9 containing the oncogene c-abl is translocated to chromosome 22

thnx uzair...really appreciate it...🙂

 

[docfromCN]

CML is charactered with overproliferation of the myeloid lineage,which leads to neutrocytosis,not lymphoytosis.