Neoplasia USMLE Step 1 Practice Question
A 9-year-old boy from equatorial Africa presents with a rapidly enlarging left jaw mass over 3 weeks. Vital signs show HR 102/min, RR 22/min, temp 38.2°C. Physical examination reveals a firm, fixed 6 cm mass without cervical lymphadenopathy. Biopsy demonstrates high-grade B-cell neoplasm with characteristic starry-sky appearance. CBC shows hemoglobin 10.2 g/dL. He denies prior chemotherapy exposure. Which molecular alteration is most likely present?
Answer choices
- At(8;14) causing c MYC overexpressionCorrect answer
- Bt(14;18) causing BCL2 overexpression
- CDeletion of 13q causing RB loss
- Dt(11;14) causing cyclin D1 overexpression
- EBCR ABL fusion due to t(9;22)
- Ft(2;8) causing IGH-MYC rearrangement with immunoglobulin kappa light chain involvement
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