What Does My Blood Test Results Indicate?

Posted on Fri, 24 Oct 2014

Question: Does a CBC/differential show the same as a smear. Would it show abnormal cells and report it? Concerned about blood cancer. I believe my spleen is enlarged. I hook fingers under bottom of left rib cage directly below nipple and take a deep breath. something solid/rubbery hits fingers. Could this be blood cancer? ultra sound said spleen 14.5 and ct with contrast said within normal limits. Why does something hit my fingers just under ribs if spleen is fine. Concerned......follow up on 13th with doc.

CBC with Differential and Iron test:
wbc-10.4
rdw-11.8
rbc-5.71 million
Plt-307 thou
TIBC-416
% Saturation-15%
Iron-61

neut%-66.9
Mon %-10.5
lympho%-21.3
Eos%-.906
baso%-.386

absolute neuts - 6.99
absolute monos-1.1
absolute lymps-2.22
absolute eos-.095
absolute basos- .040

differential method-auto

hgb-17.2
hct-48.7
MCV-85.3
mchc-35.3
mch-30.1

Answered by Dr. Robert Galamaga (16 minutes later)

Brief Answer:
Considerations

Detailed Answer:
Thanks for sending the question,

I see no signs of cancer. Your complete blood count is absolutely normal. The automated differential is calculated by a machine. A manual differential is actually evaluated by a medical doctor. Since you have a normal white blood cell count, normal hemoglobin and normal platelet count it is highly unlikely that you have some type of blood cancer.

Regarding what you are feeling under your rib cage it is possible that it might be the spleen. Generally we are able to feel the spleen in patients who are relatively thin in stature. From what you have provided including the imaging evaluation of your spleen there is not appear to be any evidence of blood cancer or lymphoma.

I am confident that your doctor will also have a similar impression.

Thanks again for sending her question. Please let us know if you have any additional specific concerns.

Sincerely,

Dr. Galamaga

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Robert Galamaga (19 minutes later)

Thank you Doctor for the extremely quick response! Does the differential show abnormal cells if there are any or does that have to be done manually? I am 5'10 200 pounds so I thought my spleen should not be felt especially that far forwards. This is what concerned me. CBC said wbc high by .2 and the monocyctes were slightly high as well. So I was just trying to find out what would cause the spleen to be where it is and the slight elevation in Wbc specifically moncytes. Fyi my wbc was 10.4 five years ago when I had my last CBC. Being able to feel what I think is my spleen is what brought this to a head. Also had full liver work up with tumor markers, autoimmune, and XXXXXXX test. All normal. thank you doctor and sorry for such a long follow up! Thank you for your time, I appreciate all of your help.

Answered by Dr. Robert Galamaga (45 minutes later)

Brief Answer:
Considerations

Detailed Answer:
Thanks for the followup. I completely understand your concern. Your white blood cell count is just slightly above 10. It has been stable for a while it is most likely not a big deal.

I think you have had an extensive amount of testing so far. Her daughter will likely recommend repeating blood counts every 6-12 months to see if anything changes. Your doctor might also request a flow cytometry study which can also help identify if there are any abnormal circulating white blood cells. Please talk about this with him.

Regarding other question the automated machine can pick up abnormal cells and will generally flag them on the report.

Sincerely,

Dr. Galamaga

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Robert Galamaga (26 minutes later)

Thank you Dr. Galamaga! Last question and I really appreciate all of your responses.....they are helping the nerves while trying to figure this out. I know a ct trumps an ultrasound so I assume the spleen is normal but on the large end of normal. I could never feel it before but it has been like this for 3 months(discomfort below ribs made me start probing under rib). Should I wait and get a scan in 6 months if it does not get bigger or earlier if it gets bigger? If it is not portal hypertension from liver, blood cancer, cancer, and probably not ebv since I am 36 what might cause the increase in size? Is there any tests in addition to the flow cytometey study you think might be pertinent? Thank you again for all of your time and knowledge!

Answered by Dr. Robert Galamaga (1 hour later)

Brief Answer:
Followup

Detailed Answer:
I would try and wait 6 months to get another followup imaging study.

There are several things which can cause changes in the size of the spleen including viral infections, fluctuations in pressure in the system involving the liver and spleen, the portal system. Certain blood disorders as you have mentioned can also cause this but I do not see overwhelming evidence of a blood disorder for you. Of course anything as possible and we need to watch very closely.

The flow cytometry study can sometimes pick up abnormal cells circulating within the body. See if your doctor think this is reasonable to perform. Otherwise would wait another 6 months and get another scan done.

In the meantime it is very important that you focus on maintaining a healthy lifestyle with good exercise and healthy diet.

Sincerely,

Dr. Galamaga

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Robert Galamaga (34 minutes later)

Thank you Dr.Galamaga! I really appreciate the time you spent assisting today and answering all my questions. On your reply I will close out.

I will bring this up to the doctor on the 13th and see if she is good with the study. Right now the spleen does not seem to be getting any bigger from when I first felt it.

Since the initial ultrasound in July I have lost 60 pounds on purpose due to the scare. I walk at lunch run 2 miles in the evening and only eat 3 small meals. I will continue as you stated.

Thank you again for hanging in there with me, and all of your answers! Take care Dr. Galamaga!

Answered by Dr. Robert Galamaga (2 hours later)

Brief Answer:
Followup.

Detailed Answer:
it was an absolute pleasure to discuss your healthcare concerns.

Sincerely,

Dr. Galamaga

Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar