Haematological malignancy in practice

Question 1

What are common causes of tiredness?

Answer 1

Anaemia (also includes bleeding)

Depression

Hypothyroidism

Malignancy)

Question 2

What can cause iron deficiency alongside B12 deficiency?

Answer 2

Gastric cancer

Investigation would be upper GI endoscopy

Question 3

What are the causes of marked splenomegaly?

Answer 3

—Low grade lymphoma (splenic enlargement would probably be a bone marrow lymphoma crossover)

—Chronic leukaemias (CML, CLL)

—Myeloproliferative disorders

—Portal hypertension / liver disease

—Infiltration from sarcoidosis, other malignancies

—Infections eg chronic malaria, visceral Leishmaniasis

Question 4

What are the genetic markers for myeloproliferative disorders?

Answer 4

JAK2

CALR

MPL

Question 5

What are causes of lymphocytosis?

Answer 5

—Viral infection (e.g. EBV, CMV, HIV)

—Other infections – TB, brucellosis, syphilis

—Vasculitis

—Acute lymphoblastic leukaemia

—Chronic lymphocytic leukaemia

—Lymphoma