A 67-year old man, with a past medical history significant for basal cell carcinoma, presented with prominent constitutional symptoms including high spiking fever, generalized pruritus, fatigue and 18 pound weight loss over 2 months. The patient underwent an upper gastrointestinal endoscopy and the possibility of gastric tumor was ruled out. Whole body computed tomography revealed generalized lymphadenopathy involving bilateral axillary, mediastinal, hilar, abdominal, retroperitoneal, bilateral iliac and inguinal regions. Bilateral pleural effusions were also noted.
All intra-abdominal organs including liver and spleen were unremarkable. Initial laboratory tests revealed mild thrombocytopenia and raised alkaline phosphatase levels. Multiple blood cultures and urine culture were negative. Microscopic Features The histologic sections of the inguinal biopsy specimen demonstrate a lymph…
