Case 27-2001.

The article describes the case of a 50-year-old man with marked splenomegaly and anemia. He had been in good health until he began to have progressive exertional dyspnea, aching in the legs and pain in the left arm after walking 8 to 10 meters. His physician found that he had splenomegaly and a hematocrit of 31 percent, and the patient was referred to a hospital. Physical examination revealed multiple excoriated, crusted lesions on the skin of the hands and feet, splenomegaly to the level of the umbilicus and firmness of the left hepatic lobe.