This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pathology
[{'content': 'A 6 year old child presents with pallor that required two blood transfusions previously. He has now developed fever and petechial haemorrhages.His hemoglobin is 9 g/dL, platelet count is 20,000/mm3 and TLC is 60,000/ mm3. Flow cytometry reveals the cells to be CD10 +ve, MPO +ve, CD 19 +ve, CD 33 –ve, CD 117 +ve, and CD3 –ve.\nWhich of the following is the most likely diagnosis? \nSelect and explain. \nA. ALL, B. AML, C. Mixed phenotypic leukaemia, D. Undifferentiated leukaemia', 'role': 'user'}, {'content': 'Answer: C \nExplanation: Mixed lineage acute leukemia is alternatively also known as bilineal acute leukemia. As\xa0suggested by the name, there\xa0are 2 populations of cells which are morphologically and immunophenotypically distinct from each other.\nAnalyzing the markers on the cells,\n\nB lymphoid markers: CD10, CD19 and CD79.\nT lineage markers: CD2, CD3 and CD7.\nMyeloid markers; CD13, CD33, CD117 and myeloperoxidase (MPO).\nNon lineage specific markers which are expressed in hematopoietic progenitor cells: CD34, HLA-DR and TdT. Comparing this with the information provided in the stem of our question, it is easy to decipher that the cells mentioned are CD10+ve, MPO +ve, CD19+ve, CD33-ve, CD117 +ve and CD3-ve which is showing both lymphoid (CD10, CD19;B lymphoid lineage) and myeloid (CD117 and MPO+-; myeloid lineage) markers.\n\nSo, the answer is\nMixed phenotypic leukemia\nA word about the last option ‘d’, please note that in un-differentiated acute leukemia, blasts usually lack any evidence of lineage differentiation.\nWintrobes 12th/1814-8', 'role': 'assistant'}]