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July 24, 2017
High-Risk Primary Myelofibrosis
- A 53-year-old woman complains of increasing abdominal discomfort, early satiety, and 15-lb weight loss over the past 5 months
- Abdominal examination reveals splenomegaly, palpable 8 cm. below the costal margin without hepatomegaly
- CT scans of the chest, abdomen, and pelvis reveal moderate mediastinal lymphadenopathy and splenomegaly
- Laboratory values:
- WBC: 1.9 x 103cells/mm3
- ANC: 1.4 x 103cells/mm3
- Hb: 9.1 gm/dl
- Platelets: 77,000 cells/mm3
- Bone marrow biopsy:
- MF-3
- CD34+/CD117+ immunostaining demonstrated 1.2% blasts
- JAK2-V617Fmutation
- Diagnosis: primary myelofibrosis