Case 21-1977

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Abstract
Presentation of Case First admission. A 48-year-old man was admitted to the hospital because of fever.He was well until 21 months previously, when he began to experience exertional dyspnea and fatigue. A physician found pancytopenia and referred him to this hospital. Examination revealed pallor, purpura, retinal hemorrhages and enlargement of the liver and spleen. An x-ray film of the chest showed a rounded nodule, 1 cm in diameter, in the left-upper-lung field; the lungs appeared normal in other respects, and the heart and mediastinum were normal. Fluoroscopic examination of the chest confirmed the presence of a calcified granuloma . . .
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