Twenty patients with ill-defined complaints of 7 months' to 10 years' duration were studied intensively for a hidden neoplastic focus. A diagnosis of preclinical lymphoma in the prediagnostic phase was made in all 20 patients on the basis of detailed clinical and laboratory tests. The appearance and persistence of an abnormal reticulum cell in leukocyte concentrates of peripheral blood was the most reliable procedure. Eighteen of the 20 patients developed lymphomatous disorders 2 to 26 months after the presumptive diagnosis of prelymphoma was made. Follow-up studies have been continued on the remaining two patients. One has persistent leukopenia and the other an unexplained mast-cell infiltration of the marrow.
Bierman HR, Marshall GJ, Winer ML. The Prediagnostic State of Lymphoma: Detection and Description. JAMA. 1963;186(3):185–192. doi:https://doi.org/10.1001/jama.1963.03710030025004
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