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64-year-old female with 1 week of swelling, right leg. Swelling resolves after lying down at night. No other symptoms.
Abdominal mass on pelvic exam.
Barium enema prior to admission: negative for colon mass IVP: right pelvic mass
CXR: negative for masses
Abdominal exploration, omentectomy, TAH and BSO, dissection of L iliac nodes: Atrophic uterus; lymphoma of the left iliac lymph nodes, dissected and resected; liver and spleen appeared free of disease.
Iliac lymph nodes: Follicular, small cleaved cell lymphoma
Inguinal lymph nodes: no evidence of tumor
Tubes and ovaries: serosal adhesions; no tumor
Bone marrow aspiration biopsy: Follicular, small cleaved cell lymphoma infiltrating the bone marrow.
Started Rituxan with Cytoxan, vincristine, and prednisone (R-CVP regimen)