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6035 Pathology

CD 19 positive, CD22 positive, CD103 positive monoclonal B-cells with bright kappa positivity were found to comprise 60% of the peripheral blood lymphoid cells on flow cytometric analysis in a 55 year old man with massive splenomegaly and a total leucocyte count 3.3 x 109/L. Which one of the following is the most likely diagnosis –

ASplenic lymphoma with villous lymphocytes
BMantle cell lymphoma
CB-cell prolymphocytic leukemia
DHairy cell leukemia
Pathology
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6038 Pathology

A 36-year-old woman has had increased malaise for 3 weeks and urine output <500 mL/day for the past 4 days. On examination, she has blood pressure 170/112 mm Hg and peripheral edema. Urinalysis shows protein 1+ and blood 3+, but no glucose or ketones. Urine microscopic analysis shows RBCs and RBC casts. Her serum urea nitrogen is 39 mg/dL, and creatinine is 4.3 mg/dL. Her serum complement C1q, C3, and C4 are decreased. A renal biopsy is performed, and immunofluorescence microscopy shows a granular pattern of staining with antibody to C3. Which of the following types of hypersensitivity reactions is most likely causing her renal disease?

AI (IgE-mediated systemic anaphylaxis)
BII (Antibody-dependent cell-mediated cytotoxicity)
CIII (Immune complex formation)
DIV (Delayed-type hypersensitivity)
Pathology
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6039 Pathology

TRALI usually is due to?

AHigh titre anti-HLA antibodies in recipient plasma
Blow titre anti-HLA antibodies in donor plasma
CHigh titre anti-HLA antibodies in donor plasma
DHPA-la on the platelet glycoprotein Ilia receptor
Pathology
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