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JAMA Cardiology Clinical Challenge
September 22, 2021

Multiple Systemic Lesions in a Middle-aged Woman With a History of Lymphoma

Author Affiliations
  • 1Joint Department of Medical Imaging, Toronto General Hospital, Toronto, Ontario, Canada
  • 2Division of Cardiology, Toronto General Hospital, Toronto, Ontario, Canada
JAMA Cardiol. 2021;6(12):1461-1462. doi:10.1001/jamacardio.2021.3566

A woman in her mid-60s, who was in remission following successful combination chemotherapy for Burkitt lymphoma 8 years previously, presented with dyspnea, fatigue, general malaise, and presyncope. On examination, she was normotensive, afebrile, and clinically euvolemic. Laboratory testing showed a hemoglobin level of 12.1 g/dL (to convert to grams per liter, multiply by 10), white blood cell count of 9900/µL (to convert to ×109 per liter, multiply by 0.001), erythrocyte sedimentation rate of 76 mm/h, lactate dehydrogenase level of 139 U/L (to convert to microkatals per liter, multiply by 0.0167), and normal coagulation profile. Serum immunoglobulin quantitation showed normal immunoglobulin (Ig) G, IgA, and IgM levels of 1590 mg/L, 303 mg/L, and 94 mg/L, respectively (to convert to grams per liter, multiply by 0.01). Blood culture findings were negative.

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