An 80-year-old woman was admitted with pancytopenia. Five weeks earlier, nausea, vomiting, diarrhea, chills, and fever had developed. CT revealed bilateral pelvic masses; examination of a peripheral-blood smear revealed schistocytes, anisocytosis, and a low platelet count. A diagnostic test was performed, and management decisions were made.
Funding and Disclosures
This case was presented at the Medicine Case Conference.
Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.
We thank Dr. Walter H. Dzik for his assistance with preparing the conference and Dr. Judith A. Ferry for her assistance with the pathological portion of the conference and manuscript.
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