Question

A 69-year-old man presents for an examination. He does not have a personal physician, and he has not had a physical since he was enlisted in the army. His physical examination is normal. Blood pressure is normal. He notes that he has had problems with rectal itching and burning pain. He has had a cold for 3 weeks, and it does not appear to be getting any better. Other than these 2 complaints, he has been relatively healthy. Laboratory tests are ordered and the results are shown in the table.

On peripheral smear- smudge cells; fragile B cells are noted.

Based on these test results and the clinical history of the patient, what is the most likely diagnosis?

Answer 1

The most likely diagnosis for the 69-year-old man is chronic lymphocytic leukemia (CLL).

Step-by-step explanation:

The most likely diagnosis for the 69-year-old man based on the clinical history and test results is chronic lymphocytic leukemia (CLL). The presence of smudge cells and fragile B cells on the peripheral smear are indicative of CLL. Additionally, the patient's symptoms of rectal itching and burning pain, along with a persistent cold, can also be attributed to CLL. CLL is a type of cancer that affects the lymphocytes, which are a type of white blood cell.