17-year-old boy presented with complain of petechiae. O/E ,sternal tenderness is present. BM biopsy show hypercellularity and more than 20% Lymphoblast. Peripheral smear show ||| TLC and presence of lymphoblast . On X ray. retrosternal mass is seen. All are true about condition patient is suffering except?
Above patient is most likely suffering from T-cell ALL. Points in our of above diagnosis: Peak at pubey Retrosternal mass More than 20% Lymphoblast( Tdt +, PAS +) in BM ||| TLC Lymphoblast present in blood Less common than B cell ALL Thymus ++ Notch gene mutation Gain of function Poor prognosis CD1/2/5/7 positive Immunophenotyping of immature T-cell phenotype : Tdt/CD34/CD7 positive
It has good prognosis
Notch gene mutation present
An immature T-cell phenotype (Tdt/CD34/CD7 positive)
Thymic involvement is seen
Acute Lymphoblastic Leukemia