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An 81-year-old woman was admitted with increasing generalized weakness, anorexia, and a weight loss of 7 kg (15 lb) over the previous three months. The only finding on physical examination was marked cachexia. Laboratory evaluation revealed anemia (hemoglobin level, 7.4 g per deciliter), leukocytosis (white-cell count, 15,400 per cubic millimeter), and thrombocytosis (platelet count, 450,000 per cubic millimeter). The chest radiograph showed a sclerotic 11th rib on the right side (Panel A, arrows). Subsequent bone scanning showed homogeneous uptake along the entire affected rib (Panel B, arrows). Bone marrow biopsy and rib biopsy led to a diagnosis of diffuse large-cell . . . [Full Text of this Article] |
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