L4

A 60 year old patient presents to the office for a routine physical. She complains of fatigue and notes she has felt this way for a while. Her CBC shows mild anemia and thrombocytopenia. A peripheral smear and bone marrow biopsy/aspirate are obtained.  The cells are, CD5, CD23, CD38 positive.

·         Peripheral smear:

·         A positive CD5+ stain is associated with which two forms of lymphoid cancer?

·         What do the cell markers represent?

·         How do you know the cells are monoclonal in nature?

·         5-10% of patients develop an aggressive large B cell lymphoma: what is this transformation called? 

·         Why is the patient anemic?