Hematologic Malignancies USMLE Step 1 Practice Question
A 9-year-old boy from equatorial Africa presents with fever (38.5°C), tachycardia (110 bpm), and a rapidly enlarging jaw mass over two weeks. Biopsy shows sheets of medium-sized lymphocytes with numerous tingible body macrophages creating a starry-sky appearance. LDH is markedly elevated at 1,200 U/L. Abdominal imaging reveals no hepatosplenomegaly. He denies recent antibiotic use. Which genetic abnormality is most likely present?
Answer choices
- At(11;14) causing cyclin D1 overexpression
- Bt(14;18) causing BCL2 overexpression
- CDeletion of 13q causing retinoblastoma loss
- Dt(9;22) causing BCR ABL fusion
- Et(8;14) causing c MYC activationCorrect answer
- Ft(2;5) causing NPM ALK fusion
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