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A case of an 8-year-old female presented with a four-week history of cough. On clinical examination, she was found to have hepatomegaly and splenomegaly along with generalized lymphadenopathy.

The image shows a hypercellular bone marrow owing to a diffuse infiltration by large pleomorphic neoplastic cells. These cells showed dispersed chromatin, multiple prominent nucleoli, and irregular nuclear contours, with occasional horseshoe-shaped nuclei noted. Immunohistochemical studies demonstrated positive CD30, ALK1, and CD3 on neoplastic cells.