A 52-year-old man presents with progressive fatigue, early satiety, and unintentional 8-lb weight loss over 2 months. Vital signs: BP 138/82, HR 102, RR 18, Temp 37.2°C, SpO2 98% on room air. Examination reveals massive splenomegaly; no lymphadenopathy noted. Laboratory studies show WBC 87,000/μL with left shift (increased myelocytes and metamyelocytes), basophilia, and low leukocyte alkaline phosphatase score. Hemoglobin 10.2 g/dL. Which of the following is the most likely underlying abnormality?
- A)Deletion of the p53 gene
- B)t(9;22) creating a constitutively active tyrosine kinaseGABARITO
- C)t(8;14) causing c MYC overexpression
- D)t(14;18) causing BCL2 overexpression
- E)JAK2 activating mutation
Explicação
t(9;22) creating a constitutively active tyrosine kinase is correct. Chronic myelogenous leukemia is caused by the BCR ABL fusion gene, which drives uncontrolled myeloid proliferation. The low LAP score helps distinguish CML from leukemoid reaction, and spleno... Ver explicação completa e trilha adaptativa →