Anemia and thrombocytopenia: diagnosis from the blood smear

Abstract

A 74-year-old nonsplenectomized male who had cutaneous squamous cell carcinoma of the scalp with locoregional metastases presented to the emergency room for altered mental status. He had completed metastasectomy and chemoradiation 2 months earlier. Imaging studies revealed no evidence of disease. On admission, he was weak and disoriented and had diarrhea. Complete blood count revealed mild anemia (hemoglobin 11 g/dL) and thrombocytopenia (platelet count 54 3 10 9