Hematologic Malignancies USMLE Step 1 Practice Question
A 52-year-old man with a 10-year history of hepatitis C presents to the clinic with a 3-month history of fever, night sweats, and unintentional weight loss of 8 pounds. On physical examination, temperature is 38.2°C, and there is marked splenomegaly. Laboratory studies show WBC 15,000/μL with 65% lymphocytes, hemoglobin 10.5 g/dL, and platelets 95,000/μL. Peripheral blood smear reveals small lymphocytes with scant cytoplasm. Serum protein electrophoresis shows monoclonal IgM spike, and cryoglobulins are detected. Lymph node biopsy demonstrates B-cell infiltration that is CD5+, CD19+, and CD23+. Which of the following is the most likely diagnosis?
Answer choices
- AChronic lymphocytic leukemia
- BHepatitis C-associated lymphoproliferative disorder with mixed cryoglobulinemiaCorrect answer
- CSplenic marginal zone lymphoma
- DDiffuse large B-cell lymphoma
- EHodgkin lymphoma
- FBurkitt lymphoma
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