Body fluid analysis, CBC, serology and bone marrow aspirate karyotype at time of pericardial relapse
| Pericardial fluid | |||
| Result | Units | Normal range | |
| Glucose | 77 | mg/dL | |
| Protein | 4.1 | g/dL | |
| LDH | Greater than 2500 | U/L | |
| Flow cytometry | 16% monotypic plasma cells. Positive for CD138 and CD38, with kappa light chain restriction. Negative for CD56, CD19, CD20, CD45 | ||
| FISH | Gain of chromosome 9, t(4;14), and a monosomy for chromosome 13 | ||
| Aerobic and anaerobic culture | No growth | ||
| Blood | |||
| Result | Units | Normal range | |
| WBC | 51.5* | ×109/L | 3.6–10.6 |
| RBC | 3.27 | ×1012/L | 4.21–5.92 |
| Hb | 105 | g/L | 12.8–17.7 |
| Hct | 31.8 | % | 37.5–50.9 |
| MCV | 97.4 | fL | 79.5–96.8 |
| MCH | 32.0 | pg | 26.2–33.1 |
| MCHC | 32.8 | g/dL | 32.6–35.0 |
| RDW | 14.6 | % | 12.0–16.2 |
| Platelets | 151 | X10(3) | 162–427 |
| MPV | 6.4 | fL | 7.0–10.9 |
| Myelocytes | 2 | % | |
| Neutrophils bands | 11 | % | 0–10 |
| Atypical lymphocytes | 1 | % | 0 |
| Neutrophils segmented | 78 | % | 40–75 |
| Lymphocytes | 5 | % | 12–47 |
| Monocytes | 1 | % | 4–12 |
| Metamyelocytes | 2 | % | 0 |
| LDH | 307 | U/L | |
| Protein | 5.3 | g/dL | |
| SPEP | |||
| Result | Units | Normal range | |
| Protein | 4.7 | g/dL | 6.0–8.5 |
| Albumin | 2.8 | g/dL | 3.2–5.6 |
| Protein monoclonal | Not observed | g/dL | |
| Kappa + lamda light chains (LCs) free with kappa/lambda ratio | |||
| Results | Units | Normal range | |
| Ig LC kappa free | 11.04 | mg/L | 3.30–19.40 |
| Ig LC lamda free | 11.00 | mg/L | 5.71–26.30 |
| LC kappa/lambda | 1.0 | 0.26–1.65 | |
| Bone marrow aspirate | |||
| Result | Interpretation | ||
| Karyotype | 46, XY | No evidence of an acquired clonal abnormality | |
*In the setting of stem cell mobilisation.
CBC, complete blood count; FISH, fluorescence in situ hybridization; Hb, haemoglobin; Hct, haematocrit; LDH, lactate dehydrogenase; MCH, mean corpuscular haemoglobin; MCHC, mean corpuscular haemoglobin concentration; MCV, mean corpuscular volume; MPV, mean platelet volume; RBC, red blood cell count; RDW, red cell distribution width; SPEP, serum protein electrophoresis; WBC, white blood cell count.