NAPZATIVE SULOMARY
DATE OF DiacKanar

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BSMWELA OF DATS HOSPITALIZED

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LEZ nottreshfls and S22 lymphocytes.

Hest of the piccical

examination was seid

ts kove kot meormal et that tima. Throuchoct this extire period the patient has
boon untiscl acraptomatic exrest for nerrousnes? md e fora of ¢cysphacia “n which
he hes cares. ak sxtllesing certain foodsPerteculoriy stesxs amc scm tices
besourvers Eutiemt deeerfres this es cecaurvine esoccislic Uf he is the k est bit
ancuocue uu. Ciffienlty occurs tha food sams to lo’ce in tha lover part of

ton ietehoe.n peoderine en exemueisating cain which is relicvad only ty brincine the
f.00 U.orer.

Tre patient has hed a eeneidcrable exount of domestic difficulty in

tho poct ecvrercl years and otherwire his histery is mrenariable.
eliims to bo ropmotenstic at this tine.

The patient

POOL. Ie PPP TINY

Reveals aman who 4s prematurely bald but states
thet his beldness berm et cere 20. Appears
ecicvately nourished. "Ws veishs 119 lbs. andstends 5'9® tall. Flood
oS wyTos pulse €0. Entire physical exetinaticon vasa eseentially mmremarkable.

cho... cut Liver are not eilargped.

Tha only lysmn nedcs thet are palretle are

gMwvol gc cllbh shetty nodes in the inruinal r ¢ions cine somewhat larger node in the
Df. emilee“TYTreen snd a very small half 1 pee sinc ssdo in the vosterior cervical
a eyo ee vod coats
eee OTE OU ee

RAED TATION TTA

VDRL was nonereactives. He-orran revealed 22,700
white blood cells, 70% lymphocytes, 30% neutrophils,

Lom civisn eclis were noted. Hamoclobin wat 13 eros, hematocrit 11. Corrected
gicritotion rate 19, Urdmalysis revealed no simifiscmt sescmality. The blood
ctrl wic repeated on three occasions, white comt varyine between 22;000+27,000
mo. “otbeams a lymphocytosis of approximately 707. Fliatelct comt was 222,000.

Urie gtk

* 302 Roh
ucS.

LE prep wes negative.

Chest xercy revealed no sipnifirant

hos? ite,
aria shadow revenied a Schatski Jcfornity of tne laver esophagus
Sool Im tabs indieetes a hictes hernia.

ET Oe TI CtwTTole

Patient wee asymotomatic threnchout his hosritel
story. Bone marrow aspiration was carried out and
cad eric g ce Tia)ar marrow with normil calluler comommmts. There is no

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evl.ctgs cf 4nfiitretive dicaass or exeessiws i-eturity. An attenpted aiorsy of
tre Leech neve which cas felt to be pelnable in the ri ht cervical chain was carried
cut
‘et umfortemetely no lymph node was identified in ths curcical soecimen material.

Votfomt was eocn dic consultation by the eenaltant in bematolory who felt thet

goginenecst. of lenkesda or ane other epeciMe herstolovi-al disaase conl? ret be

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RARRATIVE SUMMARY

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CLITICAL RECORD
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