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36284 Medicine

A 48 year old woman was admitted with a history of weakness for two months. On examination, cervical lymph nodes were found enlarged and spleen was palpable 2 cm below the costal margin. Her hemoglobin was 10.5 g/dl, platelet count 237 x 109/L and total leukocyte count 40 x 109/L, which included 80% mature lymphoid cells with coarse clumped chromatin. Bone marrow revealed a nodular lymphoid infiltrate. The peripheral blood lymphoid cells were positive for CD 19, CD 5,CD 20 and Cd 23 and were negative for CD 79 B and FMC – 7.What is the most likely diagnosis ?

AT - cell rich B - cell lymphoma with leukemic spill over in blood.
BChronic lymphocytic leukemia
Cmantle cell lymphoma
DA definite diagnosis can not be made in this patient without lymph node biopsy.
Medicine
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