An aggressive discovery in a teen

Dr Tricia Wright, FRACP, FRCPA, Haematologist

CLINICAL examination shows bilateral cervical and supraclavicular lymphadenopathy. He is afebrile and there are no other findings. A full blood count, E/LFTs, EBV serology and an ESR are requested.

Later that day the results are sent through electronically with an urgent review flag. These show: Hb 133g/L (140–180), WCC, 26.3 x109/L (4-11), platelets, 71 x 109/L (150–450). BLOOD FILM PENDING.

He also has hypercalcaemia 3.1mmol/L (2.10–2.60) and renal impairment

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