Case 28-1980

Presentation of CaseA 62-year-old man was admitted to the hospital because of fever.He was well until six years previously, when he noticed enlarged lymph nodes but did not seek medical treatment. Seven months before entry he came to the medical clinic, where examination showed extensive lymphadenopathy and massive splenomegaly. The hematocrit was 26.5 per cent; the white-cell count was 520,000, with 1 per cent neutrophils and 99 per cent small lymphocytes. The platelet count was 126,000, and the reticulocyte count 2.1 per cent. An x-ray film of the chest revealed that the heart was enlarged; the hilar areas . . .