July 16, 2018


March 2017

  • A 67-year old woman presents to her primary care physician with complaints of fatigue, abdominal fullness, night sweats, and 17-lb weight loss over the past 6 months.
  • PMH includes hypertension, controlled on enalapril 10 mg
  • Abdominal examination reveals spleen palpable 7 cm below the costal margin
  • Lab values:
    • HGB: 9.2 gm/dl
    • Platelets: 189 x 109/L
    • WBC: 19 x 109/L
  • Bone Marrow Biopsy:
    • MF-3
    • CD34+/CD117+ immunostaining demonstrated 1.2% blasts
    • JAK-V617F mutation
  • Diagnosis: Primary myelofibrosis