Haematology: chronic lymphocytic leukaemia: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Haematology: chronic lymphocytic leukaemia

Sample item

A 68-year-old man has asymptomatic lymphocytosis of 60,000/microlitre. The blood film shows mature small lymphocytes with many smudge cells. Flow cytometry would most likely show co-expression of which markers?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. CD5 and CD23 on B cells

Chronic lymphocytic leukaemia is a mature B cell neoplasm that co-expresses CD19, CD20 (weak), CD5 and CD23. Smudge cells are fragile lymphocytes crushed on film preparation. CD10 with TdT suggests B-ALL, and CD13 and CD33 suggest myeloid blasts.

Option by option

  • A. CD13 and CD33

    CD13 and CD33 are myeloid markers seen in AML.

  • B. CD3 and CD7 only

    CD3 and CD7 mark T cells, whereas CLL is of B cell lineage.

  • C. CD10 and CD19 with TdT

    CD10 and TdT mark immature lymphoblasts, not mature small lymphocytes.

  • D. CD5 and CD23 on B cells (correct)

    Correct. The CD5 and CD23 combination defines classic CLL.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is D, CD5 and CD23 on B cells. Chronic lymphocytic leukaemia is a mature B cell neoplasm that co-expresses CD19, CD20 (weak), CD5 and CD23.

Why is "CD13 and CD33" not the answer?

CD13 and CD33 are myeloid markers seen in AML.

Why is "CD3 and CD7 only" not the answer?

CD3 and CD7 mark T cells, whereas CLL is of B cell lineage.

Why is "CD10 and CD19 with TdT" not the answer?

CD10 and TdT mark immature lymphoblasts, not mature small lymphocytes.

What concept does this question test?

It tests Haematology: chronic lymphocytic leukaemia in Pathology. Smudge cells are fragile lymphocytes crushed on film preparation. CD10 with TdT suggests B-ALL, and CD13 and CD33 suggest myeloid blasts.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haematology: chronic lymphocytic leukaemia?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.