= Solution
\b[<Leucocythaemia> was the historical description of a persistent excess of white corpuscles in the <blood>, commonly accompanied by enlargement of blood-forming or lymphoid organs.] The corresponding modern disease group is <leukaemia>, but a raised <leukocyte> count alone is not a sufficient modern diagnosis.
A period investigation would compare the proportions and appearances of the white and red corpuscles in a fresh blood preparation and examine the <spleen>, <lymph nodes> and <liver>. Splenic enlargement could be striking, and enlarged lymphatic glands supplied another important pattern. The white material was not simply <pus> circulating from an unnoticed <abscess>; microscopic resemblance between a <leukocyte> and a pus corpuscle does not establish suppuration. A persistent excess must also be distinguished from a temporary reactive rise during <infection> or <inflammation>.
In present terms, <leukaemia> comprises malignant disorders of blood-forming cells. Acute and chronic forms, and myeloid and lymphoid lineages, differ in the maturity and identity of their abnormal cells and in their course. <Bone marrow> disease can interfere with normal production of <red blood cells>, <platelets> and functioning <leukocytes>. Thus pallor, fatigue and breathlessness may reflect <anaemia>; bruising or bleeding may reflect inadequate <platelets>; recurrent <infection> can occur despite a large total white count. Infiltration or enlargement of the <spleen>, <lymph nodes> and <liver> can produce swelling, early satiety or abdominal discomfort.<Leukaemia by Cancer Council Australia>[Definition, major classifications, symptoms and organ enlargement]{ref}
The useful modern examination includes a complete <blood count> and differential, a stained <blood film>, and investigation of <bone marrow> and cellular markers when indicated. The morphology and proportions of mature and immature cells matter. A count can be normal or low in some <leukaemias>, while a high count can have a non-malignant cause.<White Blood Count by MedlinePlus>[Interpretation: a count alone cannot confirm a diagnosis; differential, film and marrow investigations]{ref} \b[The historical appearance suggests a disorder of blood formation, but classification requires more than counting white cells.]
Back to article page
