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June 13, 1977

Lymphomatoid Granulomatosis Presenting as Fever of Unknown Origin

JAMA. 1977;237(24):2633-2634. doi:10.1001/jama.1977.03270510055026

IN 1972, Liebow et al1 published a description of lymphomatoid granulomatosis (LYG), an angiocentric and angiodestructive lymphoreticular proliferative disorder that predominantly involves the lungs. We report a case that presented in a manner not previously described in literature.

Report of a Case  A 26-year-old man was admitted to USAF Hospital, Bitburg, Germany, on July 1, 1974, with complaints of fever, ataxia, diplopia, and a 4.5 kg weight-loss over a three-month period. On physical examination his body temperature was 38.3 °C orally. Axillary and inguinal adenopathy, hepatosplenomegaly, hyperactive deep tendon reflexes, ankle clonus, and Babinski's sign were present. Auscultation and percussion of the chest were unremarkable as was the chest roentgenogram. Hematocrit, alkaline phosphatase, creatinine phosphokinase (CPK), and total bilirubin levels were normal. Total WBC count ranged from 1,400 to 3,100/cu mm. Contrast roentgenogram of the upper gastrointestinal tract, SGOT, EEG, and biopsy specimens of the liver and right inguinal