Intermittent

Blood & Lymphoreticular System


{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This middle aged lady has presented with severe constitutional symptoms in association with progressive abdominal swelling - a highly sinister presentation.\n\nExamination reveals the presence of several alarming findings: pallor, hepatomegaly, and most remarkably, massive splenomegaly (i.e. enlargement \u003E 20 cm).\n\nVery few conditions give rise to massive splenomegaly in adults; these include chronic myelogenous leukemia (CML), myelofibrosis, lymphoma, visceral leishmaniasis, and chronic malaria.\n\nNote that leishmaniasis and malaria are unlikely, given the absence of travel to an endemic region.\n\nIn addition, the absence of peripheral lymphadenopathy makes lymphoma clinically less likely, although it cannot be excluded.\n\nCML and myelofibrosis "}]}

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