Cancer Keys: Thrombocytosis and L.E.G.O

24th February 2020

Reactive thrombocytosis can be indicator for several underlying causes, which are either self-limiting or serious. These can include infection (e.g. H.pylori), inflammation, blood loss, anaemia and a number of cancers.

Helpful hint

Depending on the presentation, NICE NG12 guidelines advise the need to investigate thrombocytosis for suspected cancer using the acronym L.E.G.O, in the following sites:

Lung: consider an urgent chest x-ray in patients over 40

Endometrial: consider an ultrasound for women over 55 with unexplained vaginal discharge or visible haematuria

Gastric: consider non-urgent direct access upper GI endoscopy for patients over 55 when present with relevant symptoms

Oesophageal: consider non-urgent direct access upper GI endoscopy for patients over 55 when present with relevant symptoms

A study by The British Journal of General Practice suggests that thrombocytosis can also be a marker of colorectal cancer, thus suggesting the use of the acronym LEGO-C to include colorectal cancer.

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