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A 37-year-old man presented with a 2-month history of unexplained fever and weight loss. He was noted to have pancytopenia, splenomegaly and hepatomegaly. HIV test was negative and no signs of infection were identified. Splenectomy yielded a 2050 gram spleen with diffuse red pulp expansion. Flow cytometric immunophenotypic studies demonstrated a population of medium to large cells expressing CD3 and gamma-delta T-cell receptors. The infiltrate was negative for EBV genomes by in situ hybridization.
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• Diffuse large B-cell lymphoma
• Extranodal NK/T cell lymphoma, nasal type
• Hairy cell leukemia
• Hepatosplenic T-cell lymphoma
• Peripheral T-cell lymphoma, unspecified
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