A 60-year-old patient visits his general practitioner because of fatigue and unexplained bruising.Physical examination revealed a frail, thin, pale man with widespread bruising.A CBC is ordered, and comes back abnormal.Peripheral blood smear examination revealed abnormal granularity of platelets and leukocytes.Red cells appear dimorphic.Bone marrow analysis is performed, and there were 20% ringed sideroblasts with dysplastic changes in RBC and WBC precursors.No cytogenetic abnormalities were detected.Based on this information, what is a probable diagnosis?

Question

Quizplus · Accepted Answer

The presence of dysplastic changes in RBC and WBC precursors, ringed sideroblasts in the bone marrow, and abnormal CBC with dimorphic red cells suggests a diagnosis of myelodysplastic syndrome. The patient's symptoms of fatigue and widespread bruising can also be attributed to this disorder. Acute leukemia typically presents with more severe symptoms such as fever, night sweats, and weight loss, while chronic lymphocytic leukemia is more common in older adults and typically presents with lymphadenopathy and hepatosplenomegaly. Myeloproliferative syndrome involves abnormal growth and proliferation of one or more cell lines, which is not seen in this patient.

A 60-Year-Old Patient Visits His General Practitioner Because of Fatigue