Dr. Goswami Parth Rajendragiri
Pathology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am a 25-year-old male suffering from joint pain and pain in the knees. I also have nausea, vomiting, gynecomastia, upper abdominal pain, rhinorrhea, and blurred vision. These symptoms got increased over a year. I have severe itching during exercising or bathing and I also develop rashes with small red dots. I used to be a healthy athlete. But now, things are not good. My gastroenterologist believed that I had lupus and tested ANA. It was positive and the antibodies were negative.
He referred me to a rheumatologist and he believed that I do not have a rheumatic disorder. I was referred to a hematologist as I had myelocytes in the peripheral blood. A bone marrow biopsy was done and it was negative for acute leukemia and I was recommended to see a rheumatologist again to do imaging. A bone scan was done and it was negative. I looked at my bone marrow results and it showed me 7.5 % hematogones. The hematogones are positive for CD 10 and CD 19. CD 10 was largely associated with many cancers and I also had a variable expression of CD 34. A subset of hematogones is positive for MPO. Does CD marker suggest a blood cancer? Please advise.
Hi,
Welcome to icliniq.com.
I have gone through the attached reports of CBC and flow cytometry (attachment removed to protect patient identity). Both of these reports does not suggest any blood cancer. CD (cluster of differentiation) marker is helpful in the identification of blood cancer and in the attached report, it does not seem to be blood cancer. Hematogones are lymphoid precursor cells and it is not blood cancer. So no need to worry about hematogones. CBC (complete blood count) does not show any abnormal malignant cells and the total count is normal and it favors the noncancerous condition. You can upload your bone marrow biopsy report. You are complaining of multiple symptoms. Kindly mention the symptoms present at present.
Patient's Query
Thank you doctor,
Currently, I have joint pain with severe pain in the knees, fatigue with insomnia, itching when exercising and after bathing, upper abdominal pain, nausea, rhinorrhea and I feel like mucus is stuck in my throat. I also have redness on my face. In regards to hematogones, it seems that most cases are diagnosed with 5 %, and in my case, I am in dark. On reading the CD 10 marker, I read many articles discussing its relation to many cancers. What is MPO and what is the sign? Hematogones are positive for MPO. What does this mean?
Hi,
Welcome back to icliniq.com.
MPO (myeloperoxidase) is a special stain for the myeloid series. White blood cells are formed from the myeloid series. So MPO positivity suggests that stained cells are myeloid series cells and not lymphocytes cells. Hematogones and CD10 positivity do not mean cancer. Your CBC report is normal. The presence of one to four percent of premature cells does not suggest any cancer. In blood cancer, premature cells are more than thirty percent at least. Your jak2 (Janus kinase 2), Exon 12, and BCR - ABL gene is negative which excludes CML (chronic myeloid leukemia) and PV (polycythemia vera) like myeloproliferative neoplasm. Bone marrow report is also normal in the attached history. However, if you have a bone marrow report copy then you can upload it and I can check it. So, I do not think that you have any form of blood cancer after reviewing all the attached reports as per my opinion. If you have anxiety, you can develop stress with fatigue, sleep disturbance, and pain. You need to do behavioral counseling. For itching, you can do allergic testing. You can follow the advice of a rheumatologist for knee pain and joint pain.
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Pathology
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