Dr. Mubashir Razzaq Khan
Hematology
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 have a few dozen pinprick-sized blood-red dots on each of my upper arms (nowhere else) for a month. I do not think they have changed since then, but it is hard to tell since there are too many to track. I had noticed them all at once, but I am not sure for how long they have been there since they are so small. My dermatologist said he thinks they are probably cherry angiomas. The Internet said an “eruption” of cherry angiomas could be a sign of malignancy. I also have had platelet clumping for the last five years. A few months ago, I had taken Nortriptyline and Gabapentin for a while. Otherwise, no other symptoms of anything are present. Are dozen of very tiny ones an eruption? Does this sound like cancer?
Hi,
Welcome to icliniq.com.
Yes, your dermatologist is right. These are angiomas, not related to blood cancer or other malignancies. To rule out any malignancies, get ESR (erythrocyte sedimentation rate), LDH (lactate dehydrogenase), and CBC (complete blood count) tests done, and send me your results.
The word leukemia means white blood cell cancer in peripheral blood. Leukemia is a relatively old term. Nowadays it is called hematopoietic and lymphoid neoplasm. A good share of circulating white blood cells comes from lymphoid tissues such as lymph nodes, spleen, thymus, etc. And the rest of the cells come from bone marrow. Lymphoid tissue is present all over the body even in the intestines, lungs, liver, etc. The neoplasms of lymphocytes white blood cells are called lymphomas which are rarely present in the blood. They are present in lymphoid tissue. However, they do infiltrate blood and bone marrow at some later stages (stage 4 disease). Now, there are certain neoplasms arising from bone marrow. They are myeloid leukemia or lymphoid leukemias. They are most of the time present in peripheral blood. In addition, leukemia and lymphoma are not merely the presence of certain types of abnormal cells. It is a whole package, comprising anemia, leukopenia or leukocytosis, high ESR, thrombocytopenia, unexplained fever, weight loss, arthralgias and myalgias, bone pain, etc. These are diagnosed using bone marrow biopsy, immunohistochemistry, flow cytometry, radiological surveying, etc. These are treated with chemotherapies, selected according to the type of cells involved in lesions.
Patient's Query
Hi doctor,
I actually had a CBC and ESR a couple of weeks ago. I did not have LDH though. Are these results sufficient? As mentioned previously, my CBC results always show a slightly lower number of platelets because of clumping over the last few years.
Hi,
Welcome back to icliniq.com.
It is good to see that your blood work reports are normal (attachments removed to protect the patient's identity). Platelet clumping is not an issue. ESR (erythrocyte sedimentation rate) is normal. There is no need for further testing. Just build up your micronutrients such as vitamin B12, folic acid, pyridoxine, vitamin D, vitamin A, vitamin C, vitamin K, calcium, zinc, phosphate, and iron.
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Hematology
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