Swelling in the right hand
Examine this figure to the right. A 33 -year-old woman came to the ER presenting with pain and swelling in the right hand; her left hand was normal (top). Although there were no apparent signs of infection, she was prescribed an antibiotic and sent home.
The following day she returned to the ER because the condition had worsened considerably and continued to progress after admittance (bottom, 1 verus 3 days after symptom onset). Tests once again revealed no sign of infection.
The woman has no history of smoking and is normotensive, is of average height and weight, and her blood metabolic profile is within normal limits. She is not diabetic and tests for hepatitisare negative. There is a family history of lymphoplasmacytic lymphoma, but the woman’s serum viscosity and lymphocyte counts were normal. What is the problem? What may be the etiology (cause) of this condition?
