Could someone take a look at this case and see if it can be certain it is a leukemia? If so, what type of leukemia is it?
The patient is a 75-year-old male in China. He went to the hospital with problems of fatigue and dizziness. Initial lab (urine & stool) tests indicated blood in stool and urine. The doctor suspected of some infection and prescribed antibiotics. After the treatment, there were still blood in urine. The doctor then suspected of some problem with the urinary tract and ordered many tests: 1.Ultrasounds for Kidneys, bladder, prostate; 2. Antibodies for Hep-B, HIV, syphilis,etc. At this time, it was discovered that the patient has syphilis antibody, together with high WBC and low platelet count. The patient could not understand how he got syphilis into his body but suspected that a blood transfusion during a surgery 8 years ago might be the culprit. After treatment of syphilis with antibiotic, the patient still has the following problems:
1. Hight WBC (12 ~ 19) and low platelet count (35 ~ 97)
2. Traces of protein and blood( ) in urine, but no white blood cell.
The doctor suspected that the patient has leukemia and ordered bone marrow tests. Here are the test results:
Complete Blood Count (latest test):
Red Blood Count: 4.83 (normal range: 4.0 - 5.5, unit: 10E12/L)
Hemoglobin: 153 (normal range: 120 - 160, unit: g/L)
Hematocrit: 43.4% (normal range: 37.0 - 50.0%)
Platelets: 68 (normal range: 100 - 300, unit: 10E9/L)
White Blood Count: 12.2 (normal range: 4.0 - 10.0, unit: 10E9/L)
Lymphocytes: 6.4 (52.3%) (normal range: 0.8 - 4.0, unit: 10E9/L, 20.4 - 51.0%)
Monocytes: 1.1 (9.0%) (normal range: 0.1 - 0.6, unit: 10E9/L, 3.0 - 12.0%)
Neutrophils: 4.5 (36.9%) (normal range: 2.0 - 7.0, unit: 10E9/L, 40.3 - 72.3% )
Eosinophils: 0.20 (1.6%) (normal range: 0.05 - 0.50, unit: 10E9/L, 0.2 - 5.0% )
Basophils: 0.02 (0.2%) (normal range: 0 - 0.10, unit: 10E9/L, 0 - 1.0% )
Leukemia Subtyping Test:
CD7: -14.06%
CD117: -15.26%
CD34: -0.14%
CD5: -18.72%
CD20: 76.32%
kappa: 58.51%
CD11c: 74.72%
CD13: -0.62%
HLA-DR: 85.86%
CD10: -0.80%
CD22: 75.92%
lambda: -16.43%
CD38: 48.12%
CD25: -0.60%
CD33: -0.56%
CD19: 65.73%
cyCD79a: 71.78%
clgM: 86.84%
slgM: -9.09%
CD103: -0.26%