Case 49-1973

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Abstract
Presentation of CaseA 27-year-old man was admitted to the hospital because of mediastinal widening.He was well until nine months previously, when he began to experience fatigue, edema, anorexia and a frontal headache on awakening, with a gain of 11 kg in weight. There was no history of sore throat or other infection, although he had been treated six months earlier for a rash on the extensor surfaces of the arms. On examination the blood pressure was 170/120. There was periorbital and + + + peripheral edema. Dullness was heard at both lung bases, and the heart was slightly . . .