The Hematologist

November-December 2016, Volume 13, Issue 6

A Stimulating Case of Leukocytosis

Jason Gotlib, MD, MS Professor of Medicine
Stanford University School of Medicine, Stanford, CA
John H. Baird, MD Fellow in Hematology/Oncology
Stanford University School of Medicine/Stanford Cancer Center, Stanford, CA

Published on: November 01, 2016

A 68-year-old woman with a history of chronic leukocytosis was referred for a second opinion. She has no significant past medical history. She has smoked a pack of cigarettes weekly for the past 30 years. She initially presented with a mild neutrophilic leukocytosis, which has been slowly progressive throughout the past 17 years (WBC 13.3-32.7 × 109/L; absolute neutrophil count 26.5 × 109/L at the time of referral). The hemoglobin and platelet count are normal. She has remained asymptomatic during this period and does not have palpable lymphadenopathy or hepatosplenomegaly on examination. A peripheral blood smear is shown below.

Image Challenge Nov Dec 16

 

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