blood test results question ?

blood test results question ?In March of this year, I had some swollen lymph nodes in my neck. I was given antibiotics which did not help. Then an Ultrasound and CT scan confirmed unspecific swollen nodes but non that are too large but they recommended follow up.

In July noticed I am itching and I have back pain and stomach issues. My WBC came back high at 13.5 and I had a CT of chest/abdomen/pelvic which was normal.
In Sept after my white blood kept staying elevated and developed other symptoms like bone, muscle, and joint pain and weight loss, I went to a great hematologist who did a bone marrow biopsy which came back with slightly hypocellular marrow 40-50 but normal otherwise. Since then my CBC have been fairly normal except for HGB ~13.7, RBC 4.4, and HCT ~ 39 in the low end of the normal range and WBC in the high end of the normal range also.
However, the following symptoms still persists: Fatigue, Flushing of skin, rashes, itching, pain in bones, muscles, joints, weakness. Recently developed some swelling behind the knees and some in the ankles. My uric acid is at 6 so it may be Gout developing. I have swollen lymph nodes in neck.

BTW, I am a male in my late 30's and I was on a medication that we later found has an unconfirmed leukemia connection. I stopped the medication in March when all this started. I also have hypothyroidism which I am on medication for.

I am at a loss of what is going on. Could this still be Leukemia? I had the bone marrow biopsy back in early Sept. As soon as a week or so ago I had CBC with manual diff which also came back normal.

How accurate is the bone marrow biopsy in detecting Leukemias?

Any ideas or thoughts would be greatly appreciated

SilenceIsDeafening
From what I've read. Doctors are usually fairly certain based on a blood test alone. The bone marrow biopsy is to confirm leukemia. So if your doctor took a blood test and a bone marrow biopsy I highly doubt it's possible they "missed" Leukemia. I hope you find out the problem soon. Good Luck!!

Denisedds
If you really like your hematologist these are the questions you should be going over with him. It is his job to figure it out. I have never seen a leukemia missed on a bone marrow biopsy. This is how they know the histology and there is no better test. It obviously is not lymphoma either. I'm sorry to tell you this will likely take several more tests to figure out. Maybe it has to do with the drug you were taking. Did you tell the hematologist about it? Have you looked into whether or not anyone else who took the drug is having the same problems?

Spreedog
The answer by Denisedds is superb.
She should be an MD. Thinking people should be MD's.
It is almost impossible to miss an acute leukemia on a bone marrow aspirate and biopsy microscopic examination by a competent pathologist and hematologist/oncologist. I assume both doctors would have looked at the slides personally. That is the only way to practice medicine.
So what is the differential white blood cell count?
It is inadequate information to only give us the total white count.
Many people have back pain and stomach issues. That helps us not.
Itching is not a specific symptom. Could be dry skin. Fatigue is a universal complaint. The uric acid level is not significant at your age.
You mention swollen lymph nodes in your neck - twice.
Many people have these from past infections.
The only way to know what they are is to have a biopsy done.
And what was the medication with the unconfirmed leukemia connection?
A 35 - 39 year old male with hypothyroidism.
Vague musculo-skeletal pains. Sounds more like an autoimmune disease if anything.
Have you had a simple ESR - sed rate? RA latex? ANA? Rheumatology consult?
You have spent a fortune on CT scans of the neck, chest, abdomen, and pelvis.
Also ultrasound imaging and bone marrow examination.
No wonder medical care is so expensive in the U.S.
This is not acute leukemia - though I would like to look at the peripheral blood smear and bone marrow aspirates myself to be sure - at no charge. Did your hematologist do that? He or she probably did - in which case - he or she should be answering this question.
Neither Denise nor I can look at your blood smears and bone marrow slides.
Heck, we don't even have the white blood cell differential report.

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