SERIES_____________________________ GROUP____________ Date______________

Name and surname:_____________________________

Case 1.

S.G.A, woman, 41 years old

Onset: laterocervical, occipital, submandibular, supraclavicular, axillary and inguinal lymph nodes (with a
maximum diameter of 3 cm), detected on August 2021, after an acute upper respiratory tract infection.

No significant APPs

Clinical: integuments and mucous membranes discretely pale, generalized adenopathy, splenomegaly
+3cm below the CR, liver with the edge below the CR.

Paraclinical:

HLG:

• RBC = 3 600 000 /mm

• Hg = 10.6 g/dl

• MCV = 72 fl

• HEM = 25 pg

Ht = 33%

• WBC (leukocytes) = 8 300/mmc

• PLT (platelets) 228,000/ mmc

Questions:

1. What other investigations are needed to establish a diagnosis?

2. Taking into account the data above, please outline a positive diagnosis.
SERIES_____________________________ GROUP____________ Date______________

Name and surname:_____________________________

Case 2

CM, woman, 43 years old

Onset: marked physical asthenia, vertigo, paresthesia of the lower and upper limbs, pain in the left
hypochondrium and flank, early satiety

APP: Lepore hemoglobinopathy; Sensitive polyneuropathy, chronic sinusitis;

Clinical: pale integuments and mucous membranes, without palpable superficial adenopathy, significant
splenomegaly +5 cm below RC, liver +2 cm below RC

Paraclinical:

HLG:

• RBC = 3 600 000 /mm

• Hb=10.4 g/dl
• MCV = 86 fl
• HEM = 28 pg
Ht = 34%

Ca serum 26 mg/dL

Serum protein electrophoresis with immunofixation:

• IgM monoclonal band present

• the monoclonal band of Kappa chains present

Immunogram:

• IgM increased twice compared to the normal value

Questions:

1. What other investigations are needed to establish a diagnosis?

2. Taking into account the data above, please outline a positive diagnosis.
SERIES_____________________________ GROUP____________ Date______________

Name and surname:_____________________________

Case 3

BM, male, 64 years old

Onset: polyadenopathy, hepatosplenomegaly

No significant APPs

Clinical: laterocervical, axillary, supraclavicular, inguinal adenopathies (with a maximum diameter of 2.5
cm), liver + 3 cm below the CR (costal border), spleen + 5 cm below the CR,

Paraclinical:

• RBC = 4,600,000/mm

• Hg = 14.6 g/dl

• MCV = 87 fl

• HEM = 30 pg

Ht = 45%

• WBC (leukocytes) = 37 300/mmc:

Neutrophils 52%

Lymphocytes 41%

Monocytes 4%

• PLT (platelets) 133,000/ mmc

Questions:

1. What other investigations are needed to establish a diagnosis?

2. Taking into account the data above, please outline a positive diagnosis.
SERIES_____________________________ GROUP____________ Date______________

Name and surname:_____________________________

Case 4

ZCV, 32 years old, female

Onset: bilateral axillary, laterocervical, bilateral inguinal polyadenopathy, without B signs present

No significant APPs

Paraclinical:

• RBC = 4,200,000/mm

• Hg = 12.6 g/dl

• MCV = 85 fl

• HEM = 30 pg

Ht = 45%

• WBC (leukocytes) = 8 300/mmc

• PLT (platelets) 172,000/ mmc

• CRP = 0.3 mg/dl

• ESR= 10 mm/h

• Fibrinogen 220 mg/Dl

• LDH= 680 U/L

Questions:

1. What other investigations are needed to establish a diagnosis?

2. Taking into account the data above, please outline a positive diagnosis.
SERIES_____________________________ GROUP____________ Date______________

Name and surname:_____________________________

Case 5

OGI. 33 years old, female

Onset: profuse night sweats, fatigue, pain when drinking alcohol, weight loss

No significant APPs

Clinical: laterocervical, supraclavicular and axillary adenopathies (diameter approx. 3.5 cm)

Paraclinical:

• RBC = 4,200,000/mm

• Hg = 12.6 g/dl

• PLT (platelets) 182,000/ mmc

• WBC (leukocytes) = 18 300/mmc:

 Neutrophils 87%

Questions:

1. What other investigations are needed to establish a diagnosis?

2. Taking into account the data above, please outline a positive diagnosis.
SERIES_____________________________ GROUP____________ Date______________

Name and surname:_____________________________

Case 6

CC, 39 years old, female

Onset: cough with repeated hemoptysis, profuse night sweats

Clinical: discreetly pale integuments and mucous membranes, inguinal, supraclavicular, laterocervical,
axillary, liver and spleen adenopathy within normal limits

APP: right condensation process, pregnancy obtained through IVF in the antecedent

Paraclinical:

• RBC = 4,300,000/mm

• Hg = 12.8 g/dl

• PLT (platelets) 192,000/ mmc

• WBC (leukocytes) = 18 300/mmc:

 Neutrophils 84%

• CRP = 3.8 mg/dl

• ESR= 32 mm/h

• Fibrinogen 560 mg/Dl

Questions:

1. What other investigations are needed to establish a diagnosis?

2. Taking into account the data above, please outline a positive diagnosis.
SERIES_____________________________ GROUP____________ Date______________

Name and surname:_____________________________

Case 7

SM, 40 years old, female

Onset: generalized integument itching started 5 years ago, fatigue

Clinical: bilateral submandibular, latero-cervical, supraclavicular, axillary lymph nodes with a maximum
diameter of 4 cm

APP: Acute edematous pancreatitis remitted under therapy; Bronchial asthma in treatment with
Ventolin

Paraclinical:

• RBC = 4,400,000/mm

• Hg = 12.5 g/dl

• PLT (platelets) 175,000/ mmc

• WBC (leukocytes) = 19 300/mmc:

 Neutrophils 86%

• CRP = 3.3 mg/dl

• ESR= 34 mm/h

• Fibrinogen 580 mg/Dl

Questions:

1. What other investigations are needed to establish a diagnosis?

2. Taking into account the data above, please outline a positive diagnosis.
SERIES_____________________________ GROUP____________ Date______________

Name and surname:_____________________________

Case 8

SDJ, age 45, female

Onset: thrombocytopenia detected 10 years ago, progressively increasing thrombocytopenia, initially

interpreted as idiopathic thrombocytopenic purpura, fatigue, loss of appetite, gingivorrhea

APP: hemorrhagic antral gastritis (2011), irritable bowel syndrome

Clinical: pale integuments and mucous membranes, bilateral axillary adenopathies (diam max 1.5 cm),
spleen +3 cm below the RC (costal edge), liver +1 cm below the RC

Paraclinical:

• RBC = 2,200,000/mm

• WBC (leukocytes) = 4 300/mmc:

• PLT (platelets) 2,000/ mmc

Questions:

1. What other investigations are needed to establish a diagnosis?

2. Taking into account the data above, please outline a positive diagnosis.
SERIES_____________________________ GROUP____________ Date______________

Name and surname:_____________________________

Case 9

BV, age 70, male

Onset: severe thrombocytopenia, splenomegaly +3 cm below the costal margin, palpable superficial
adenopathy - bilateral axillary (4 cm), supraclavicular (2.5 cm)

No significant APPs

Paraclinical:

• PLT (platelets) 45 000/ mmc

• WBC (leukocytes) = 19 300/mmc:

 Lymphocytes 41%

Questions:

1. What other investigations are needed to establish a diagnosis?

2. Taking into account the data above, please outline a positive diagnosis.
SERIES_____________________________ GROUP____________ Date______________

Name and surname:_____________________________

Case 10

SC, age 47, female

Onset: mediastinal and subdiaphragmatic adenopathies detected during a routine ultrasound

Clinical: obese patient, normally colored integuments and mucous membranes, distended abdomen due
to adipose panic, liver and spleen within normal limits

Paraclinical:

• RBC = 4,200,000/mm

• Hg = 12.6 g/dl

• PLT (platelets) 182,000/ mmc

• WBC (leukocytes) = 8 300/mmc

• CRP = 3.3 mg/dl

• ESR= 8 mm/h

Questions:

1. What other investigations are needed to establish a diagnosis?

2. Taking into account the data above, please outline a positive diagnosis.