i think someone posted this question but still - abrahem

[ArchivalUser]

and this one?

[ArchivalUser]

b?

[ArchivalUser]

splenomegaly, normal RBC morphology, pencytopenia, suggest hairy cell leukemia.

In myelofibrosis, there will be nucleated RBCs, trombocytosis

[ArchivalUser]

B is the correct answer

Pancytopenia with a dry marrow aspirate argues against CLL and myeloma. Normal RBC morphology argues against myelofibrosis. The WBC count and differential count argue against CML. Hairy cell leukemia is a neoplasm of mature B lymphocytes typically presenting with pancytopenia, splenomegaly, and a dry bone marrow aspirate. Patients with hairy cell leukemia are prone to infections with unusual microorganisms, such as atypical mycobacteria; they tend to be granulocytopenic and have a preponderance of mature-appearing lymphocytes in the peripheral blood that have, on close inspection or on ultrastructural analysis, multiple hairlike projections. Bone marrow biopsies typically yield a "fried egg" appearance in that the cells appear to be separated from one another, due to these projections and fixation artifacts generated from them. Immunophenotypically, hairy cells are characterized by the presence of mature B cell markers as well as the CD25 antigen, which is the low affinity IL-2 receptor. Fortunately, there are many treatment modalities available for patients with hairy cell leukemia. The current treatment of choice is a 7-day intravenous infusion of 2-chlorodeoxyadenosine. This single course of treatment results in complete remissions in ~80% of patients. Other effective modalities include splenectomy, interferon-á, or pentostatin (deoxycoformycin