UKMLA PLAB AMC USMLE Prometric MCQ

Question Number 0529

Question:
A 65 year old man has complaints of fatigue. He is found to have lymphadenopathy and hepatosplenomegaly. Laboratory tests are done, including a CBC with differential. His white blood count is 20,000/cu mm. 80% of the white blood cells are small, well differentiated lymphocytes. They are found to be B lymphocytes. No Auer rods are visualized. The pathologist commented that there were many 'smudge' cells. He is negative for Philadelphia chromosome. Which of the following is most likely?

a) mantle cell lymphoma
b) infectious lymphocytosis
c) Waldenstrom's macroglobulinemia
d) chronic myelogenous leukemia
e) chronic lymphoblastic leukemia