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November 29, 1919


JAMA. 1919;73(22):1697-1698. doi:10.1001/jama.1919.26120480002015b

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History.  —A negro, aged 32, seen on entrance to the prison, Dec. 20, 1918, had a large tumor in the left lumbar region which had first been noticed in March, 1917. At no time was the mass painful. The patient was born in Maryland, where he lived eight years; he then lived fourteen years in Oklahoma, and since then in California (ten years) in the Sacramento-San Joaquin Valley. He had been a waiter; he had never been around live stock. He had a sore on the glans penis in 1906 (supposedly chancre). He had a bubo in 1909, which was never opened. There was a swelling in the right supraclavicular region in 1917 at the same time as the lump in the back was first noticed. Following the diagnosis of cervical lymphatic tuberculosis, an operation was performed, after which there was a sinus for several months.

Examination.  —The patient was

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