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Pathology
A 7-year-old boy has complained of a severe headache for the past week. On physical examination, there is tenderness on palpation of long bones, hepatosplenomegaly, and generalized lymphadenopathy. Petechial hemorrhages are present on the skin. Laboratory studies show hemoglobin, 8.8 g/dL; hematocrit, 26.5%; platelet count, 34,700/mm3; and WBC count, 14,800/mm3. A bone marrow biopsy specimen shows 100% cellularity, with almost complete replacement by a population of large cells with scant cytoplasm lacking granules, delicate nuclear chromatin, and rare nucleoli. His oncologist is confident that chemotherapy will induce a complete remission. Which of the following combinations of phenotypic and karyotypic markers is most likely to be present in marrow cells from this boy?
Early pre-B CD19+ Hyperdiploidy
Early pre-B CD20+ t (9;22)
Pre-B CD5+ normal karyotype
Pre-B CD23+ 11q deletion
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