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HORIBA Medical Chase the Case #14 - Richter Syndrome
The 14th issue discusses a case with the chronic lymphocytic leukemia with transformation to Non-Hodgkin's Lymphoma, possible Richter Syndrome.
July 2022 (PDF for print)
Patient Demography: Female, 62 years old.
Diagnosis: Chronic Lymphocytic Leukemia -> Possible transformation on 8/23/19 biopsy for “Richter’s Syndrome”.
Other Information: Patient diagnosed with chronic lymphocytic leukemia since 2015, elective chemotherapy (venetoclax) with evolution to Tumor Lysis Syndrome, maintaining hyperkalemia, hypocalcemia, high uric acid, associated with general malaise, fatigue, nausea and vomiting (1 episode), diarrhea (4 episodes of yellowish liquid stools) and paresthesias.
Medicines: Elective chemotherapy (venetoclax), replacement of 4 ampoules of Calcium Chloride in total.
Other results: Ferritin 553, Iron 138, TF 1.85, ST 85, PTH 110, VIT D 23.3
Microscopic Review: Lymphocytes 59%, Neutrophils 33%. Nucleolated basophilic large atypical lymphoid cells, ranging from lymphoplasmacytoid to immature immunoblast-like forms, Thrombocytopenia confirmed on slide.
This clinical case has been provided by Dr. Cristina Rosseto, Technical Manager, Botucatu Municipal Laboratory, Brazil.
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