A 17-Year-Old Boy Is Brought to the Emergency Department for Progressive

question 325

Multiple Choice

A 17-year-old boy is brought to the emergency department for progressive fatigue.  The patient developed a cough 2 weeks ago, and for the past few days, he has become more tired due to difficulty breathing, particularly when lying down at night.  Temperature is 38.2 C (100.8 F) , pulse is 120/min, and respirations are 34/min.  Examination shows distended neck veins.  The lungs have diminished breath sounds, particularly on the left side.  Bruising and diffuse petechiae are present on the trunk, and the mucous membranes appear pale.  Chest radiography reveals a large mediastinal mass with a left pleural effusion.  The effusion is drained, and examination of the fluid shows many immature hematopoietic cells, consistent with blast forms.  Immunophenotyping of these cells would most likely reveal which of the following predominant markers?

• A)CD3, terminal deoxynucleotidyl transferase
• B)CD15, CD30
• C)CD20, surface immunoglobulin
• D)CD33, myeloperoxidase

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