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Dr. Jeffrey A. Barnes (Hematology–Oncology): A 51-year-old woman was admitted to this hospital because of anemia and splenomegaly. The patient was in her usual state of health until approximately 2 months before admission, when fatigue developed, followed by night sweats, left-upper-quadrant fullness, early satiety, edema of the legs, and dyspnea on exertion. Furosemide was prescribed, but symptoms persisted. One month before admission, she was admitted to another hospital.
On examination, the spleen extended to the pelvic brim and the legs were edematous. A direct Coombs' test was negative for IgG and complement. Other laboratory-test results are shown in Table 1
Differential Diagnosis
Benign Entities
Myeloproliferative Diseases
B-Cell Lymphomas
T-Cell Lymphomas
Anemia
Coagulopathy
Summary and Conclusions
Dr. Jeremy S. Abramson's Diagnosis
Pathological Discussion
Discussion of Management
Anatomical Diagnosis
Source Information
From the Cancer Center (J.S.A.) and the Departments of Radiology (M.C.) and Pathology (A.R.), Massachusetts General Hospital; and the Departments of Medicine (J.S.A.), Radiology (M.C.), and Pathology (A.R.), Harvard Medical School.
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