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Image Challenge

The Hematologist Image Challenge column is a collection of interactive quizzes that test readers' knowledge of different hematologic or related conditions. See below for the complete Image Challenge archives.

An Older Woman with Progressive Lymphadenopathy

November-December 2023 – In this Image Challenge, Drs. Akhil Jain, Sanam Loghavi, and Yesid Alvarado present the case of a patient presenting to clinic with progressive, bilateral neck swelling.

Orbital Tumor in a 62-year-old Patient

September-October 2023 – In this Image Challenge, Drs. Edwin Uriel Suárez, Daniel Morillo Giles, and Miguel Ángel Piris present the case of a patient presenting to clinic with progressive ptosis of the left eyelid.

A Young Man With Anemia and Neutropenia

July-August 2023 – In this Image Challenge, Dr. Sanam Loghavi presents an intriguing finding in a patient presenting to clinic with chronic fatigue.

Hyperpigmentation of the Tongue in a Patient With Lymphoma

March-April 2023 – In this Image Challenge, Drs. Edwin Uriel Suárez, Alberto López-Garcia, and Laura Solán present an intriguing finding in a patient presenting to clinic with primary mediastinal B-cell lymphoma.

Interesting Bone Marrow Finding in a Patient With Splenomegaly

September-October 2022 – In this Image Challenge, Drs. Juliana Perez Botero and Maria Hintzke present an intriguing finding in a patient presenting to clinic with splenomegaly.

ALK-Inhibitor–Induced Spheroacanthocytosis

March-April 2022 – Drs. Priscilla Yeung, Fei Fei, and Sebastian Fernandez-Pol contribute the intriguing case of a patient with metastatic lung adenocarcinoma who presented to clinic with disease progression, anemia, and associated red blood cell changes.

Quality Over Quantity: A Case of Too Many

November-December 2021 – Drs. May Chien, Clara Lo, and Bertil Glader contribute the intriguing case of a young patient with recently diagnosed anemia and sclera icterus since birth.

Quality Over Quantity: A Case of Too Big

September-October 2021 – Drs. May Chien, Clara Lo, and Bertil Glader contribute the intriguing occurrence of a patient with thrombocytopenia and family history of hearing loss at a young age.

An Unusual Case of Lymphocytosis

July-August 2021 – Drs. Andrew Levine, Constance Chen, and Sonam Prakash present the case of an older man with increased lymphocytes and other significant lab results.

Skin Changes in a Patient With Essential Thrombocytosis

May-June 2021 – Dr. Damon Houghton presents the case of a lower extremity rash in a patient with essential thrombocytosis.

The Dreaded Other Category: What's Different in This Differential?

September-October 2020 – Drs. Moe Takeda and Girish Venkataraman present the case of a persistent skin rash in a patient with a history of skin neoplasms.

Spots and Dots

July-August 2020 – Test your knowledge with an intriguing case from Drs. Pozdnyakova and Kim of a patient with end-stage renal disease status post renal transplant admitted to clinic with COVID-19.

Hyperbilirubinemia in Myelodysplastic Syndromes

May-June 2020 – Test your knowledge with an intriguing case from Drs. William Shomali, Jason Kurzer, and Peter Greenberg on the etiology of a patient's macrocytic anemia.

Bite Cells Abound

March-April 2020 – Test your knowledge with an intriguing case from Drs. Lindsey Shantzer and Kelly Davidson of a patient with anemia.

Fever in a Kidney Transplant Patient From Nigeria

January-February 2020 – Test your knowledge with an intriguing case from Drs. Karen Arispe and Alexandra Harrington of a patient with malaria.

A Skin Lesion in a Pediatric Patient: A Close Call

November-December 2019 – Take this Image Challenge by Drs. Gheorghe and Venkataraman to test the diagnosis of a pediatric patient with a skin lesion.

Spur Cell Anemia

September-October 2019 – Take this Image Challenge from Drs. Shomali, Fernandez-Pol, and Gotlib to test treatment and management of a middle-aged man with spur cell anemia.

A Woman With Thrombocytopenia Status Post-Partial Gastrectomy

July-August 2019 – Take this Image Challenge from Drs. Asif, Parker, and Aldarweesh to test the diagnosis of an elderly woman with thrombocytopenia status post-partial gastrectomy.

An Older Man With Cytopenias and Seemingly Normal-Looking Marrow

May-June 2019 – Take this image challenge from Drs. Kaumeyer, Arber, and Venkataraman featuring an older man with cytopenias after treatment of a previously diagnosed hematologic malignancy. Ancillary studies including molecular testing were needed to arrive at the diagnosis.

An Older Woman With Hemolytic Anemia

November-December 2018 – Take this Image Challenge by Drs. Shiraz Fiday and Geoffrey Wool to learn the diagnosis of a 73-year-old woman with hemolytic anemia.

A Transplant Patient With Visual Disturbance

September-October 2018 – Take this Image Challenge by Dr. Lyndsey Runaas and Dr. Steven Kroft to determine the diagnosis for a 34-year-old woman with new visual field defects.

Unusual Spindle Cell Lesion Involving Bone Marrow

July-August 2018 – In this Image Challenge, Dr. Venkataraman and Dr. Sir Philip look at a 65-year-old patient with syncope and mild hepatosplenomegaly whose blood count results prompted a bone marrow biopsy. Take a look at the bone marrow biopsy and blood smear to determine the diagnosis.

A Real Nose-Pincher

May-June 2018 – In this Image Challenge, Dr. Li and Dr. Kim present two peripheral blood smears and a bone marrow biopsy you can use to determine the cause of a patient's neutropenia.

A Man With Hyperleukocytosis and Massive Splenomegaly

March-April 2018 – Dr. Parker and Dr. Venkataraman present an image challenge that looks at the diagnosis of a man with hyperleukocytosis and massive splenomegaly.

A Man With Fevers, Headaches and Hemolytic Anemia

November-December 2017 – Take this image challenge to determine the diagnosis for a 65-year-old man who presented to clinic with one week of recurrent fevers, chills and severe headaches.

A Woman With Hypergammaglobulinemia and Diffuse Lymphadenopathy

September-October 2017 – Take the image challenge to determine the diagnosis for a woman with hypergammaglobulinemia and diffuse lymphadenopathy.

Not All Neutrophils Are Created Equal

July-August 2017 – Take the image challenge to determine what a 58-year-old man with a history of plasma cell myeloma was treated with.

Hyperleukocytosis and Abnormal Complete Blood Count

May-June 2017 – This Image Challenge looks at a 76-year-old man with a history of bladder cancer treated with two local resections and no chemotherapy or radiation, presenting to the hospital with hyperleukocytosis and an abnormal complete blood count.

Planting Evidence

March-April 2017 – Review the peripheral blood smear to determine the diagnosis of a 31-year-old man referred to hematology clinic for evaluation of long-standing thrombocytopenia.

When More (Oxygen) Is Not Better

March-April 2017 – Take the challenge to learn what test is most likely to yield the diagnosis for a case of a 58-year-old Asian woman with history of inclusion body myositis on high-dose corticosteroids and methotrexate, noted to be hypoxic.

Blasts of a Different Sort

January-February 2017 – Can you tell what the diagnosis is for a man with a history of recurrent necrotizing pancreatitis and end-stage renal disease on intermittent hemodialysis by looking at his bone marrow biopsy?

A Stimulating Case of Leukocytosis

November-December 2016 – Take the very first The Hematologist Image Challenge and try to figure out the diagnosis for a case of leukocytosis by looking at a peripheral blood smear.

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