T-cell PLL, Leukostasis and Rash in Leukemia

MKSAP
A 77-year-old man has a 1-year history of
increasing fatigue. He has not seen a
physician for at least 3 years. Medical and
family histories are unremarkable, and he
takes no medications.
On physical examination, the patient appears
pale. Temperature is normal, blood pressure
is 140/85 mm Hg, pulse rate is 72/min, and
respiration rate is 16/min. There is no scleral
icterus or jugular venous distention.
Cardiopulmonary examination is normal. The
spleen is palpable 6 cm below the left costal
margin.