A child has a splenic mass with a mediastinal mass. He appears pale, has red eyes and suffers from recurrent infections. Possible diagnosis is -

Ans. is 'a' i.e., Acute Lymphoblastic leukemia o The age group and symptoms of the child are consistent with Acute Lymphoblastic leukemia AcuteLymphoblastic leukemiao Acute lymphoblastic leukemia (ALL) encompasses a group of neoplasms composed of immature, precursor B or T (Pre-T) lymphocytes referred to as lymphoblast.Clinical manifestations of ALLo Symptoms related to depression of normal marrow function.o An accumulation of neoplastic blast cells in the bone marrow suppresses normal hematopoisis by physical crowding and competition for growth factorso This results in : - Anemia - Fatigue, palloro Neutropenia - Infection, intermittent fevero Thrombocytopenia - Bleeding, petechiae, ecchymoses, epistaxis.o These are the most common sign & symptoms.o Bone pain and tenderness resulting from marrow expansion and infiltration of the subperiosteum.o Generalized lymphadenopathy, splenomegaly and hepatomegaly Caused by neoplastic infiltration of these tissues. More common in ALL than AML.o Symptoms related to compression of large mediastinal vessels or airway In Pre-T ALL of thymuso CNS manifestation Due to meningeal involvement. -Headache, vomiting, nerve palsies. More common in ALL than in AML.o Testicular involvement is also more common in ALL than in AML.