This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Acute Lymphoblastic Leukemia, Subject name: Pathology
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? 
Select and explain. 
A. It has good prognosis, B. Notch gene mutation present, C. An immature T-cell phenotype (Tdt/CD34/CD7 positive), D. Thymic involvement is seen
A: It has good prognosis
Answer: A: It has good prognosis 
Explanation: 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