Question
A 6 years old child presents with fever, pancytopenia, generalized weakness and weight loss. On examination, he is pale with generalized lymphadenopathy. The peripheral smear of the patient has been shown below. What is the likely diagnosis?
| A. |
Aplastic anemia
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| B. |
AML
|
| C. |
ALL
|
| D. |
JMML
|
Show Answer
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Correct Answer � C
Explanation
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|
Answer- C
The given image is showing a classical image of a Lymphoblast, i.e. an abnormal immature cell with high nucleo-cytoplasmic ratio, prominent nucleoli and scant, agranular cytoplasm; typically seen in acute lymphoblastic leukemia (ALL)
ALL Histology
- The proliferation of small to medium-sized primitive cells
- In marrow or other tissue masses, effacement of architecture by round blue cells raises the differential diagnoses of ALL versus neuroblastoma, Ewing sarcoma, and others
- French-American-British classification historically described 3 morphologic variants:
- L1 blasts:
- Small with indistinct nucleoli and high nuclear: cytoplasmic ratio
- L2 blasts:
- Larger with prominent nucleoli and more abundant cytoplasm, resembling myeloblasts
- L3 blasts:
- Deeply basophilic cytoplasm and prominent cytoplasmic vacuoles, indistinguishable from Burkitt lymphoma cells
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