65 year old complains of persistent bleeding from his nose. On examination he is found to have hepatosplenomegaly and lymphadenopathy.

Question Number 0523

Question:
65 year old complains of persistent bleeding from his nose. On examination he is found to have hepatosplenomegaly and lymphadenopathy. Fundoscopy is suggestive of retinal hemorrhages. Bone radiographs are normal and renal function is preserved. A monoclonal light chain is present in the urine.He is found to have a normocytic, normochromic anemia. Serum electrophoresis reveals a a tall, narrow peak. A bone marrow biopsy is hypercellular and extensively infiltrated with lymphoid cells and plasma cells. These features are suggestive of

a) mantle cell lymphoma
b) infectious lymphocytosis
c) Waldenstrom's macroglobulinemia
d) chronic myelogenous leukemia
e) chronic lymphoblastic leukemia


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