A 6-Year-Old Boy Is Brought to the Office Due to Fatigue

A 6-year-old boy is brought to the office due to fatigue and abdominal distension.  The parents state that the patient bruises easily and appears pale.  Physical examination shows subconjunctival pallor and several ecchymoses on the boy's extremities.  His abdomen is distended with nontender massive splenomegaly and moderate hepatomegaly.  Laboratory studies reveal that his hemoglobin level is 8 g/dL, leukocyte count is 3,800 cells/mm³, and platelet count is 90,000 cells/mm³.  Bone marrow aspirate results are shown in the exhibit.  Which of the following is the most likely diagnosis?

A) Acute lymphoblastic leukemia
B) Epstein-Barr virus
C) Fanconi anemia
D) Gaucher disease
E) Parvovirus B19

Correct Answer:

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