Case 19-1972

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Abstract
PRESENTATION OF CASEA 58-year-old man was admitted to the hospital because of a progressive neurologic disorder.Twenty-one years previously he was found to have chronic lymphocytic leukemia. He felt well and received no treatment other than intermittent radiation therapy to the spleen until 16 months before admission, when there was the onset of progressive weakness and insomnia. Two months later he entered the hospital, where fever and hepatosplenomegaly were found. The white-cell count was 16,000, with 80 per cent mature lymphocytes. X-ray films of the chest showed scarring in both upper lobes and hilar calcifications; multiple cultures were negative. . . .
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