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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 348:1267-1275 March 27, 2003 Number 13
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Case 10-2003 — A 72-Year-Old Man with Rapidly Progressive Leukemia, Rash, and Multiorgan Failure
Francine M. Foss, M.D., Suzanne L. Aquino, M.D., and Judith A. Ferry, M.D.

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Presentation of Case

A 72-year-old man was transferred to this hospital from another hospital because of rapidly progressive leukemia and multiorgan failure.

The patient had lost an unknown amount of weight during the preceding two months, but he was considered to be in stable condition, with mild chronic renal failure (creatinine level, 1.9 mg per deciliter [168 µmol per liter] nine months before admission). Twenty-three days before admission, laboratory studies were performed at another hospital in preparation for an elective transurethral resection of the prostate gland (Table 1 and Table 2).

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Table 1. Hematologic Laboratory Values.

 
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Table 2. Blood Chemical Values.

 
Two weeks before admission, . . . [Full Text of this Article]

Differential Diagnosis

Lymphadenopathy and Lymphocytosis

Hypercalcemia

HTLV-I–Associated Adult T-Cell Leukemia–Lymphoma

Infectious Complications in Adult T-Cell Leukemia–Lymphoma

Other Lymphoproliferative Disorders in Adult T-Cell Leukemia–Lymphoma

Summary

Clinical Diagnosis

Dr. Francine M. Foss's Diagnosis

Pathological Discussion

Anatomical Diagnosis


Source Information

From the Department of Hematology/Oncology, New England Medical Center, and the Department of Medicine, Tufts University Medical Center (F.M.F.); and the Departments of Radiology (S.L.A.) and Pathology (J.A.F.), Massachusetts General Hospital and Harvard Medical School — all in Boston.


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