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8503 Medicine

A four year old boy was admitted with a history of abdominal pain and fever for two months maculopapular rash for ten days, and dry cough, dyspnea and wheezing for three days. One examination liver and spleen were enlarged 4 cm and 3 cm respectively below the costal margins. His hemoglobin was 10.0 g/dl, platele count 37 x 109/L and total leukocyte count 70 x 109 /L, which included 80% eosinophils Bone marrow examination revealed a cellular marrow comprising of 45% blasts and 34% Eosinophils and eosinophilic precursors. The blasts stained negative for myeloperoxidase and non-specific esterase and were positive for CD19, CD 10, CD22 and CD20. Which one of the following is the most likely diagnosis?

ABiphenotypic acute leukemia (lymphoid and eosinophil lineage)
BAcute eosinophilic leukemia
CAcute lymphoblastic leukemia with hyper-eosinophilic syndrome
DAcute myeloid leukemia with cosinophilia
Medicine
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