Hematology is a branch of medicine that deals with malignant diseases, i.e. leukemias, lymphomas, or plasmocytic myeloma, and non-cancerous blood diseases such as anemias and coagulation disorders.
Splenomegaly - is an enlargement of the spleen beyond normal size. The length of a normal spleen should not exceed 12 cm, and its weight ranges from 100-200g. A normal-sized spleen is also not palpable on examination, but it can be felt below the left rib arch when it is enlarged. The size of the spleen is objectively assessed using imaging methods (ultrasonography, CT scan). Many pathological conditions lead to enlargement of the spleen - from viral infections, autoimmune diseases, storage diseases, liver diseases or thromboembolic complications in the abdominal venous system, but also in autoimmune hemolytic anemias. Particularly large sizes of the spleen can be observed in the course of many hematological malignancies originating in the bone marrow, i.e. myelofibrosis, chronic myelogenous leukemia, and the lymphatic system (lymphomas, chronic lymphocytic leukemia).
Leukopenia - is a reduced white blood cells (WBC) count otherwise below the lower limit of normal (usually below 3.5 - 4 G/l, depending on the norms of a particular laboratory). The cause of leukopenia can be hematological diseases such as leukemia, myelodysplastic syndromes, or certain types of lymphoma, but also non-hematological diseases, including autoimmune diseases, nutritional deficiencies, chronic infections or commonly used medications. It is not always associated with a disease state, but this can only be determined after ruling out a number of conditions leading to its development. Leukopenia may or may not lead to an increased risk of infection.
Leukocytosis - is an increased number of white blood cells above a WBC level of >10 G/L. It most often occurs in the course of bacterial or other infections, but a suddenly rising leukocyte count or persistently elevated leukocytes over time requires an in-depth hematological diagnosis. Leukocytosis occurs in the course of leukemia, lymphoma or myeloproliferative neoplasms, among others.
Anemia is a situation in which we observe a reduced hemoglobin (Hb) level and the total number of red blood cells (RBC, red blood cells). Norms for Hb levels vary - in women, anemia is diagnosed when Hb<12 g/dl (7.4 mmol/l) and in men <13 g/dl (7.7 mmol/l); note that the norm for the laboratory where the test was performed should be taken into account. Initial symptoms are quite nonspecific, including weakness, palpitations, difficulty concentrating, dizziness, pale skin, lethargy, cracking of the corners of the mouth, increased brittleness of the nails or hair loss. A number of genetic (so-called congenital) as well as acquired diseases can lead to anemia. Acquired causes include deficiencies of iron, vitamin B12, autoimmune diseases such as celiac disease, chronic diseases (i.e. kidney disease, inflammatory diseases), solid tumors and hematological diseases. Among anemias, there are:
Polycythaemia (polyglobulia) - is defined as a condition when blood count shows an elevated level of hemoglobin (Hb >16.5 g/dl in women, Hb >18.5 g/dl in men). Hypercoagulability can occur in the course of malignant disease of the bone marrow (mainly verrucous melanoma), but it can also be the result of other diseases (then we speak of secondary hypercoagulability), i.e., lung or heart disease, or compulsive smoking, consumption of drugs. Hypercoagulability, like hypercoagulability, is associated with an increased risk of thromboembolic complications. Symptoms of hypercoagulability can include itchy skin after a hot bath, a bluish-red facial coloration, and in the advanced form, weakness, and poor exercise tolerance. Elevated arterial blood pressure may also be one of the symptoms.
Thrombocytopenia - is a reduction in platelets below normal values (PLT <150 G/l). This condition can be led by disorders of platelet production (so-called central thrombocytopenia in the course of myelodysplastic syndromes, lymphoma, leukemia or bone marrow fibrosis) and their excessive destruction (so-called peripheral thrombocytopenia in the course of autoimmune diseases, infections or drug use). Platelets are responsible for the clotting process; hence their deficiency can lead to prolonged bleeding, a tendency to bruising or the appearance of petechiae on the skin or mucous membranes.
Thrombocytemia - is an increased platelet count above the upper limit of normal (PLT >450 G/l) leading to an increased risk of thromboembolic complications such as pulmonary embolism or deep vein embolism. The causes of thrombocytemia vary and may be related to iron deficiency, hematologic diseases (myeloproliferative neoplasms), inflammation and infections.
Hepatomegaly - is the term for liver enlargement. The causes are very diverse similar to splenomegaly. Also, ultrasound or computed tomography scans are used to evaluate the liver. Most often, liver enlargement is observed in the course of liver diseases such as viral infection hepatitis, steatosis, cirrhosis or storage diseases. Liver enlargement is also observed in heart failure. Neoplastic diseases can also lead to enlargement of this organ due to the presence of metastases of solid tumors or in the course of hematological malignancies, i.e., chronic myeloproliferative diseases, lymphomas or chronic lymphocytic leukemia. Often, liver enlargement is accompanied by changes in blood morphology in leukopenia, anemia and thrombocytopenia.
Lymphadenopathy - is used to describe the enlargement of lymph nodes above normal size, i.e. 1-1.5 cm (in the case of inguinal nodes, 1.5-2 cm). In addition to the size of the lymph nodes, their soreness, mobility in relation to other structures, hardness, or the presence of skin lesions in the area of the enlarged node are also important in assessing them. Also important is the location of the enlarged lymph node and whether it is a single or multiple lymphadenopathy (enlargement of multiple groups of lymph nodes). The causes of lymphadenopathy vary widely, with viral and bacterial infections being the most common causes. In addition, enlarged lymph nodes are observed in autoimmune and neoplastic diseases (hematologic malignancies and solid tumor metastases). The imaging evaluation of lymph nodes uses ultrasound, computed tomography, magnetic resonance imaging or positron emission tomography (PET-CT). Surgical biopsy of a lymph node combined with histopathological examination is often the only method to determine the cause of lymphadenopathy.
It is a medical condition in which clots form in blood vessels (veins or arteries) in various body parts. Otherwise, the condition is referred to as thrombosis. The clot formation may be asymptomatic, but it leads to symptoms associated with impaired blood flow over time. A particular form of venous thromboembolism is the occlusion of the pulmonary arteries, referred to as pulmonary embolism. This is an immediate life-threatening condition requiring urgent diagnosis and treatment.
An increased risk of thrombosis is found in people:
Thrombophilia is defined as a condition with an increased risk of thrombosis. The causes of thrombophilia can be both congenital (deficiencies in the proteins responsible for the regularity of clotting and clot dissolution) and acquired (associated with the presence of medical conditions). The risk of developing thrombophilia depends on many factors, and treatment should be selected individually. Knowing the cause of thrombophilia is important to choose the correct post-treatment and treatment because anticoagulant treatment in certain patients with thrombophilia should be continued for life.
When should thrombophilia be suspected and testing for thrombophilia is recommended?
Testing for thrombophilia is recommended if:
The term hemorrhagic diathesis is used to describe the tendency to excessive and abnormal bleeding in unprovoked and post-traumatic situations due to disturbances in blood clotting processes. Symptoms can vary widely, depending on the organ involved, comorbidities, medications taken or the type of hemorrhagic diathesis.
Symptoms suggestive of hemorrhagic diathesis include: