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Case Records of the Massachusetts General HospitalFree Preview

Case 11-2022: An 80-Year-Old Woman with Pancytopenia

List of authors.
  • Rebecca K. Leaf, M.D.,
  • Ranjodh S. Dhami, M.D.,
  • Nancy S. Chun, M.D.,
  • and Robert Ta, M.D.

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.

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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.

Author Affiliations

From the Departments of Medicine (R.K.L., N.S.C.), Radiology (R.S.D.), and Pathology (R.T.), Massachusetts General Hospital, and the Departments of Medicine (R.K.L., N.S.C.), Radiology (R.S.D.), and Pathology (R.T.), Harvard Medical School — both in Boston.

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