A 35 year old patient admitted secondary to sever parlor (symptoms of malaise for 4 weeks).

Treated on and of in a peripheral hospital (typhoid, brucellosis, amebiasis, malaria and TB). On physical exam, severely anemic, no lymphadenopathy, and no petechiae. Abnormal: massive splenomegaly, WBC -17, HB-4, Platelets 47. a. b. c. d. Outline the rest of history from the patient. History of fever History of poor vision Headaches, confusion, dyspneoa Any joint or bone pain Presence of gum hypertrophy History of night swaets Exposure to radiation or any carcinogenic compounds Smoking history or history of tobacco use Family history of disease Existing Genetic abnormalities such as trisomy21, fanconis anemia List at least important diagnostic investigations to be carried Peripheral blood film Bone marrow Examination Biopsy andaspirate Flow Cytometry UECs hyperuicemia Coagulaiton Profile: Increases Prothrombin Time Fibrin D-Dimer present Chest X ray showing mediastinal mass Molecular studies: Take the most likely differential and outline its management List 10 differential diagnosis Acute leukemia Lymphoproliferative disorders Lymphoma Chronic lymphocytic leukemia Hairy cell leukemia Myeloproliferative diseases Myelodysplastic syndromes Rheumatoid arthritis (Felty syndrome) Systemic lupus erythematosus Serum sickness Sarcoidosis Thyrotoxicosis