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144556 Pathology

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, platelet 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, CD10, CD22 and CD20. Which one of the following is the most likely diagnosis –

ABiphenotypic acute leukemia (lymphoid and eosinophil lineage)Acute eosinophilic leukemia)
BAcute lymphoblastic leukemia with hypereosinophilic syndrome
CAcute myeloid leukemia with eosinophilia
DAll
Pathology
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