A 60 Years Retired Education Officer complaining of Cold & Cough before one month primarily he was taking antihistamines and symptomatic treatment but since he is complaining of mild headache and cough not expectoration I advised him for do peripheral smear with CBC count ESR to ruled out cause but when results were came his ESR is raised and TLC is also increased so as per the situation I advised him for bone marrow aspiration I send all the reports since I am a general physician i further cannot manage this case since my provisional diagnosis is Chronic Myeloid Leukemia ? kindly opine on this case and advise me the needful please with if possible then suggest treatment also

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Lymphoma T Cells CUTANEOUS T-CELL LYMPHOMAS (CTCL) About CTCL Tumors of Lymph nodes and Lymphatic system are called Lymphomas.  Extranodal lymphomas are the tumours that occur in organs or tissues outside the lymphatic system. When lymphomas occur in the skin having no evidence of disease  anywhere else at the time of diagnosis , they are called Primary  Cutaneous Lymphomas . There are many types of Primary Cutaneous Lymphomas, but two main categories are Cutaneous T- cell Lymphomas (CTCL) and  Cutaneous B-Cell Lymphomas (CBCL). 65% of Cutaneous Lymphomas are T-Cell type. The diagnosis is made by Skin Biopsy. CTCL is a serious and very uncommon skin condition in which there is an abnormal neoplastic proliferation of lymphocytes with a T- Subtype ( T is Thymus Derived). CLASSIFICATION OF CTCL Mycosis Fungoides – The sub types areFolliculotropic MFPagetoid ReticulosisGranulomatous Slack skin Primary Cutanoeus CD 30 + Lymphoproliferative DisordersPrimary Cutaneous anaplastic large cell lymphomaLymphomatoid papulosisSubcutaneous PanniculiticPrimary Cutaneous CD4 + small/medium pleomorphic T-Cell Lymphoma, usually presented with a single lesion and progresses slowely. In Primary Cutaneous Lymphomas, Mycosis Fungicides is the most common types of CTCL in 50 % of cases. The second most common is Primary Cutaneous CD30 + Lymph proliferative disorders. MYCOSIS FUNGOIDES  The  name mycosis is confusing and seems that it is a fungal infection. But it has nothing to with it. It is a condition in which the skin is infiltrated by patches or lumps composed of white cells called lymphocytes. Men are more common to have it than women and very rare in children. The cause of the disease is unknown , in some cases it may be associated with infections with retrovirus or pre-existing contact allergic dermatitis. Mf may persists in one stage or over the year or sometimes decades , it slowly progress to another stage. PATCH STAGE The lesions are flat in this stage, oval or ring shaped, pink dry patches on covered skin.  They may remain in the same size or slowly enlarge. The skin may be atrophic , itching may or may not be there. The differential diagnosis from Psoriasis , Discoid Eczema or ParaPsoriasis is difficult in this stage. PLAGUE STAGE In this stage the patches become thickened and may resembles psoriasis. This stage is usually itchy. TUMOUR STAGE In this stage of Mycosis Fungoides ,the large irregular lumps develop from plagues. Ulceration may occur in the lesions. This is a critical stage where it spread to the other organs . The tumour stage may transform to a large cell lymphoma. AYURVEDIC VIEW ON CUTANEOUS T-CELL LYMPHOMA (CTCL) The pathology starts due to the formation of “ama” the toxin produced by the faulty digestion.  Poor digestion forms immature “rasa”  or chyle . This is the main culprit to develop  any disease. In CTCL the dosha becomes disturbed due to the faulty rasa dhatu. All the three doshas gets vitiated  and produce their symptoms. Deranged vata produces pain . Deranged pitta produces inflammation and heat. Deranged Kapha produced rigidity.  The imbalances of the dosha causes the “ Rasa vaha Strotas Dushti” , “ Medh vaha strotas Dushti”  and “Masma vaha Strotas dushti” and the channels (Srotas ) gets blocked . The proper nutrition doesn’t reach to them due to nutrition deficiency the muscles  &  skin  becomes weak and diseased.
Thanx Sir for Ur value Information
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LEUKAEMOID REACTION NO LEUKAEMIA. DUE TO CHRONIC VIRAL INFECTION....RAISED ESR,LYMPHOCYTIC REACTION
Thanx sir
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Bone marrow is producing excessive lymphocytes.
Tanks sir
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Chanderprabha Vati - 2 tablets, twice daily, with plain water, after meals.Punarnava Mandur - 2 tablets, twice daily with plain water after meals.Wheat Grass Powder - 1 teaspoonful, twice daily, mixed in a glass of water.Aarogyavardhini Vati - 2 tablets, twice daily, with plain water, after meals.
Need Constitutional treatment.
Thanx sir
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Blood test for Dengue.
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Varicose. Veins.