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A 4-year-old child presented with fatigue, malaise, fever, sore throat, headache, nausea, abdominal pain and myalgia. On examination generalized lymphadenopathy and hepatosplenomegaly was noted. There was marked tonsillar enlargement along with palatal petechiae, rashes and edema of the eyelids. Peripheral smear is given below.Paul Bunnel test was performed and was positive. All of the following except one can be caused by the above organism?

A
Nasopharyngeal carcinoma
B
Non Hodgkins Lymphoma
C
Diffuse gastric carcinoma
D
Primary effusion lymphoma.
High-Yield Explanation
1st image shows tonsillitis with membrane formation in infectious mononucleosis. Peripheral blood film shows atypical lymphocytes or Downey cells are lymphocytes that become large as a result of antigen stimulation.

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