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B-cell lymphocytosis

T Cell

Viral infection (EBV, CMV, influenza, hepatitis, HTLV) Bordetella pertussis Syphilis

Mycobacterium tuberculosis

Serum sickness Thyrotoxicosis Addison disease Postsplenectomy

Serum sickness Thyrotoxicosis Addison disease Postsplenectomy

EBV, Epstein-Barr virus; CMV, cytomegalovirus; HTLV, human T-lymphotrophic virus.

toms may be associated with rheumatoid factor.6 It is uncommon for progressive adenopathy to produce pain, airway or vascular compromise, or obstruction of the gastrointestinal tract. Organomegaly, particularly splenomegaly, also occurs with progressive disease. Splenomegaly is usually painless, but may cause early satiety and bloating. Patients with CLL can have exaggerated reactions to mosquito or other insect bites.7-9 The pathophysiology for this hyperresponsiveness is unknown.

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