History

4 year old female with history of frequent upper respiratory infections.

Fever and sore throat for several days. Found to have decreased WBC and platelet counts, as well as hepatosplenomegaly. Referred for evaluation of possible malignancy.

Physical Exam

Pale child with light blonde "silver streaked" hair, light gray-blue eyes, and photophobia.

Her liver and spleen were both palpable approximately 8 cm below the respective costal margins.

CBC & Diff