#00062927

3.5 yrs old child presented with fever, Right cervical lympadenopathy with progresive increase in size, splenomegaly, bilateral proptosis for past 2 months. Her hemoglobin was 3.3 g/dl, Total WBC count was 3780/cumm, with normal paltelet count. Periperal blood smear revealed few tear drop RBCs, 2 NRBCs/100 WBCs.CT scna revealed multiple lytic lesions over the bony calvaria, mediastinal widening.  Bone marrow was done which showed blue round small cell tumour with some rosettes. Neuropril was also evident. Flow cytometry revealed predominant cell in absent CD 45/SSC with positivity for CD 56 and negativity for CD 19, CD 10, CD 79a, TdT, cCD3. On the basis of morphology and flow cytometry possibility of Neuroblastoma was suggested which wass later confirmed on Immunohistochemitry on bone marrow biopsy with psoitivity for NSE, Synaptophsyin and negativity for CD 99, TdT, Myogenenin