Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Does The Following Pathology Report Suggest?
Question: I received my pathology report back from the VA. I would like to know what a few things mean.
(1) The lymphocytes and monocytes have a benign mixed polymorphous appearance.
(2) There are rare microcytes and macrocytes.
(3) The platelets appear to correlate with the count given, having normal morphology with rare large platelet forms.
I do not have an appointment with the VA for over a month. I am curious about number one and two's meanings.
Also, is it possible for Hemochromatosis to go into one's bone marrow if it shifts course out of the blood? I have been near anemic for almost 9 months now. My ferritin level is 22 currently. My weight is 106 pounds at 5ft 10inches. I go into detail below.
Thank you.
Sincerely,
XXXX
(1) The lymphocytes and monocytes have a benign mixed polymorphous appearance.
(2) There are rare microcytes and macrocytes.
(3) The platelets appear to correlate with the count given, having normal morphology with rare large platelet forms.
I do not have an appointment with the VA for over a month. I am curious about number one and two's meanings.
Also, is it possible for Hemochromatosis to go into one's bone marrow if it shifts course out of the blood? I have been near anemic for almost 9 months now. My ferritin level is 22 currently. My weight is 106 pounds at 5ft 10inches. I go into detail below.
Thank you.
Sincerely,
XXXX
Brief Answer:
I would recommend bone marrow study and stool test for occult blood.
Detailed Answer:
Hello mam,
I did review your concern.
Your ferritin level is low which is seen with hemochromatosis person with extensive treatment in terms of phlebotomy or chelators or due to bleeding.
Since you had gastritis there can be chronic small amount of bowel bleeding that can cause this problem.
Regarding your questions
When they say monocytes and lymphocytes have benign mixed polymorphous appearance they are usually meaning in terms of shape and size of these cells indicating they largely look benign.
Rare microcytes and macrocytes are very common findings however they can be seen in iron deficiency anemia, vitamin b12 anemia and sideroblastic anemia.
Hemochromatosis does not affect the bone marrow that much. It affects major organs like heart, pancreas, pituitary glands, skin. However I have seen cases of fibrosis in patient with long standing hemochromatosis , but they are relatively infrequent.
If your hemoglobin levels are lower than 12gm/dl or they have fallen in past 2-3 months i would advice
-further evaluation in terms of bone marrow study to know the cause of anemia. -along with it a stool test for occult blood will help.
I hope this helps.
wish you all the best.
let me know if you have any more questions or concerns mam.
thank you for choosing healthcaremagic.
sincerely,
Dr Parth Desai
I would recommend bone marrow study and stool test for occult blood.
Detailed Answer:
Hello mam,
I did review your concern.
Your ferritin level is low which is seen with hemochromatosis person with extensive treatment in terms of phlebotomy or chelators or due to bleeding.
Since you had gastritis there can be chronic small amount of bowel bleeding that can cause this problem.
Regarding your questions
When they say monocytes and lymphocytes have benign mixed polymorphous appearance they are usually meaning in terms of shape and size of these cells indicating they largely look benign.
Rare microcytes and macrocytes are very common findings however they can be seen in iron deficiency anemia, vitamin b12 anemia and sideroblastic anemia.
Hemochromatosis does not affect the bone marrow that much. It affects major organs like heart, pancreas, pituitary glands, skin. However I have seen cases of fibrosis in patient with long standing hemochromatosis , but they are relatively infrequent.
If your hemoglobin levels are lower than 12gm/dl or they have fallen in past 2-3 months i would advice
-further evaluation in terms of bone marrow study to know the cause of anemia. -along with it a stool test for occult blood will help.
I hope this helps.
wish you all the best.
let me know if you have any more questions or concerns mam.
thank you for choosing healthcaremagic.
sincerely,
Dr Parth Desai
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you, Dr. Dr Parth Desai,
What would be a reason for my ferritin level dropping to 22 without undergoing phlebotomy for nine months? The VA is mandated by law not to give a patient phlebotomy unless their ferritin level is above 50 due to the risk of making the patient anemic. I have not had chelators either. Therefore, in the last nine months instead of my ferritin level rising, as one would think it would due to the lack of phlebotomy, it has continued to drop. However, my iron saturation level has continued to rise. This shift in my Hemochromatosis has left me feeling fatigued, losing weight, breaking out in two different forms of rashes that have been diagnosed (Psoriasis and Granuloma annulare), and increase in joint pain.
My question is:
Is there a term for when the Hemochromatosis suddenly takes a different route out of the blood into the organs making a patient near anemic without phlebotomy being the causal factor?
Thank you for your help and support. It is greatly appreciated.
Sincerely,
XXXX
What would be a reason for my ferritin level dropping to 22 without undergoing phlebotomy for nine months? The VA is mandated by law not to give a patient phlebotomy unless their ferritin level is above 50 due to the risk of making the patient anemic. I have not had chelators either. Therefore, in the last nine months instead of my ferritin level rising, as one would think it would due to the lack of phlebotomy, it has continued to drop. However, my iron saturation level has continued to rise. This shift in my Hemochromatosis has left me feeling fatigued, losing weight, breaking out in two different forms of rashes that have been diagnosed (Psoriasis and Granuloma annulare), and increase in joint pain.
My question is:
Is there a term for when the Hemochromatosis suddenly takes a different route out of the blood into the organs making a patient near anemic without phlebotomy being the causal factor?
Thank you for your help and support. It is greatly appreciated.
Sincerely,
XXXX
Brief Answer:
I would recommend the following mam
Detailed Answer:
Hello. Thank you for your reply query mam.
It is interesting that your ferritin levels have dropped despite no phlebotomy or chelation therapy,
usually it can be due to iron deficiency anemia. But since your iron saturation is also high, it seems less likely.
I would like to rule out sideroblastic anemia sometimes associated with hemochromatosis or iron overload. Second possibility is anemia of chronic disease or anemia secondary to bone marrow fibrosis. It could also be due to bleeding from gastrointestinal tract. your gastritis can cause small amounts of bleeding daily to cause loss of iron stores however it could be from somewhere else too.
Hemochromatosis can cause various organ manifestations like liver, heart and pancreas etc problems. And chronic liver disease can cause anemia of chronic disease. but it is rare if you donot have concomitant jaundice to begin with. There is no specific term for hemochromatosis suddenly taking a specific different route but organ dysfunction due to hemochromatosis can theoretically manifest as anemias.
So the next best step would be to go for a bone marrow aspiration study along with repeat complete blood count and a stool test for occult blood. Also please repeat the iron studies again to confirm the laboratory findings.
I hope this helps
Wish you all the best mam.
Also please let me know if you have any more concerns.
Sincerely,
Dr Parth Desai
I would recommend the following mam
Detailed Answer:
Hello. Thank you for your reply query mam.
It is interesting that your ferritin levels have dropped despite no phlebotomy or chelation therapy,
usually it can be due to iron deficiency anemia. But since your iron saturation is also high, it seems less likely.
I would like to rule out sideroblastic anemia sometimes associated with hemochromatosis or iron overload. Second possibility is anemia of chronic disease or anemia secondary to bone marrow fibrosis. It could also be due to bleeding from gastrointestinal tract. your gastritis can cause small amounts of bleeding daily to cause loss of iron stores however it could be from somewhere else too.
Hemochromatosis can cause various organ manifestations like liver, heart and pancreas etc problems. And chronic liver disease can cause anemia of chronic disease. but it is rare if you donot have concomitant jaundice to begin with. There is no specific term for hemochromatosis suddenly taking a specific different route but organ dysfunction due to hemochromatosis can theoretically manifest as anemias.
So the next best step would be to go for a bone marrow aspiration study along with repeat complete blood count and a stool test for occult blood. Also please repeat the iron studies again to confirm the laboratory findings.
I hope this helps
Wish you all the best mam.
Also please let me know if you have any more concerns.
Sincerely,
Dr Parth Desai
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
