Hematopathology Practice Questions

Q: An infant presents with bony pain and dermatitis on the scalp. Skull X-ray and electron microscopy of a biopsy from a lesion are provided. What is the most probable diagnosis?

Langerhans cell histiocytosis. ***Langerhans cell histiocytosis*** - **Classic triad** in infants includes **bony lytic lesions**, **scalp dermatitis**, and **diabetes insipidus**, with skull X-ray showing characteristic **punched-out lesions**. - Electron microscopy reveals pathognomonic **Birbeck granules** (tennis racket-shaped organelles) within Langerhans cells, confirming the diagnosis. *Multiple myeloma* - Primarily affects **adults over 60 years**, making it extremely rare in infants and children. - Presents with **hypercalcemia**, **renal dysfunction**, and **anemia** rather than scalp dermatitis. *Thalassemia* - Characterized by **hemolytic anemia**, **splenomegaly**, and **growth retardation** due to defective hemoglobin synthesis. - Does not cause **lytic bone lesions** or **dermatitis**; instead shows **extramedullary hematopoiesis**. *Acute myeloid leukemia* - Presents with **pancytopenia**, **bleeding**, and **infections** due to bone marrow infiltration by malignant cells. - Does not typically cause **punched-out skull lesions** or **scalp dermatitis** seen in this case.

Question 1

CD19 positive, CD22 positive, CD103 positive monoclonal B-cells with bright kappa positivity were found to comprise 60% of the peripheral blood lymphoid cells on flow cytometric analysis in a 55-year-old man with massive splenomegaly and a total leucocyte count of 3.3 x 10^9/L. Which one of the following is the most likely diagnosis?

Accepted Answer

Hairy cell leukemia

Answer

Splenic lymphoma with villous lymphocytes

Answer

Mantle cell lymphoma

Answer

B-cell prolymphocytic leukemia

Question 2

Which of the following statements about stored blood is false?

Accepted Answer

It is a good source of platelets.

Answer

It can be stored for up to 40 days.

Answer

Potassium levels increase during storage.

Answer

Factors V and VIII are deficient in stored blood.

Question 3

ADAMTS13 is associated with which of the following disorders?

Accepted Answer

Thrombotic thrombocytopenic purpura (TTP)

Answer

Churg-Strauss syndrome

Answer

Wegener's granulomatosis

Answer

Membranous nephropathy

Question 4

An infant presents with bony pain and dermatitis on the scalp. Skull X-ray and electron microscopy of a biopsy from a lesion are provided. What is the most probable diagnosis?

Accepted Answer

Langerhans cell histiocytosis

Answer

Multiple myeloma

Answer

Thalassemia

Answer

Acute myeloid leukemia

Question 5

Which of the following is NOT a cause of Disseminated Intravascular Coagulation (DIC)?

Accepted Answer

Acute myeloid leukemia M1 subtype

Answer

Falciparum malaria

Answer

Trauma

Answer

Carcinoma of the pancreas

Question 6

All are seen in Thalassemia major EXCEPT?

Accepted Answer

Macrocytic anemia

Answer

Transfusion dependency

Answer

Hepato-splenomegaly

Answer

Target cells

Question 7

"Autosplenectomy" is a feature seen in:

Accepted Answer

Sickle cell anemia

Answer

Hereditary spherocytosis

Answer

G6PD deficiency

Answer

Thalassemia minor

Question 8

What is the characteristic finding in chronic myeloid leukemia?

Accepted Answer

Reduced score of alkaline phosphatase in granulocytes

Answer

Reduced score of acid phosphatase in granulocytes

Answer

Total lack of platelets

Answer

Total lack of neutrophils

Question 9

Auer rods are specific for which of the following conditions?

Accepted Answer

Acute myeloid leukemia

Answer

Acute lymphocytic leukemia

Answer

Chronic lymphocytic leukemia

Answer

Hodgkin's lymphoma

Question 10

Plasmacytoid lymphomas may be associated with which immunoglobulin?

Accepted Answer

IgM

Answer

IgG

Answer

IgA

Answer

IgE

Hematopathology — MCQs

Hematopathology — MCQs

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