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What Does This CT Scan For Abdominal Pain Indicate?

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Posted on Fri, 23 Dec 2016
Question: I am a 77 year old male. I was in ER for abdominal pain. CT scan showed lesions on spleen growing in size and number due to either plaque build or blood disorder. Liver also enlarged. I had a XXXXXXX stroke the next week...head CT also showed plaque build up in arteries, Yet, I've always had low cholesterol, normal BP, yearly physicals normal...healthy diet.

Initial blood work showed high: Leukocytes (15.3x10^9/L), RDW CV (16.0), platelets (761 x10^9/L), ABS neutrophil (10x10^9/L), ABS monocytes (1.4x10^9/L). I was given blood thinners and antibiotics. Blood work 2 weeks later showed high: Leukocytes (11.9x10^9/L), RDW CV (15.9), platelets (949 x10^9/L), ABS neutrophil (6.7x10^9/L), ABS monocytes (3.2x10^9/L), eosinophil 0.6x10^9/L.
I'm worried it is cancer.
doctor
Answered by Dr. Hardik Sanghvi (2 hours later)
Brief Answer:
It can be essential thrombocythemia or reactive thrombocytosis.

Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.

You have splenic infarct and XXXXXXX stroke with many plaques in artery.

Your hemogram suggest that your platelets count is very high. It can be due to chronic myeloid XXXXXXX at I've disease like essential thrombocytopenia or just reactive thrombocytosis.

High platelets increase the viscosity of blood and blood becomes more thick and it increase the chance of clotting.

You should go for testing to confirm or rule out essential thrombocytopenia. Go for bone marrow examination and jak 2 mutation study. These will help you to confirm the diagnosis.
Then plan accordingly. Till that time continue blood thinner drugs according to advice.

Give me follow up with your reports.

Hope I have answered your question.
If you have any doubts then feel free to ask me. I will be happy to answer.
Thanks for using health care magic. Wish you very good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Hardik Sanghvi (45 hours later)
Thank you,
I had blood work done yesterday. I started taking hydroxyurea (50mg/day) today for 3 months and they are checking for Jak2 and DNA-pcr.

My blood work from yesterday showed my platelet count to be 801x10^9. It's gone down from 949 blood work taken on Nov. 27th. Could that be from the blood thinners?

Also, my RDWCV is still high (15.8), yet my MCV is in normal high range (94 FL) normal..What can this be a sign of?
thanks!
doctor
Answered by Dr. Hardik Sanghvi (2 hours later)
Brief Answer:
It is good sign if your platelets count decrease.

Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.

If your platelets count decrease then it is good sign. If it decrease further then there is chance that it can be due to reactive thrombocytosis. Blood thinner does not affect platelet count much. Don't worry about slightly high RDW. It is not much significant.

Continue your hydroxyurea. Give me follow up with your reports. Repeat platelets count after 15 days.

Hope I have answered your question.
If you have any doubts then feel free to ask me. I will be happy to answer.
Thanks for using health care magic. Wish you very good health.
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Hardik Sanghvi

Hematologist

Practicing since :2008

Answered : 7043 Questions

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What Does This CT Scan For Abdominal Pain Indicate?

Brief Answer: It can be essential thrombocythemia or reactive thrombocytosis. Detailed Answer: Hi, dear I have gone through your question. I can understand your concern. You have splenic infarct and XXXXXXX stroke with many plaques in artery. Your hemogram suggest that your platelets count is very high. It can be due to chronic myeloid XXXXXXX at I've disease like essential thrombocytopenia or just reactive thrombocytosis. High platelets increase the viscosity of blood and blood becomes more thick and it increase the chance of clotting. You should go for testing to confirm or rule out essential thrombocytopenia. Go for bone marrow examination and jak 2 mutation study. These will help you to confirm the diagnosis. Then plan accordingly. Till that time continue blood thinner drugs according to advice. Give me follow up with your reports. Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you very good health.