Lymphomatoid granulomatosis. Report of a patient with severe anemia and clubbing.

We report a 31-year-old man in whom initially localized lymphomatoid granulomatosis was diagnosed at left pneumonectomy. He had severe anemia which is rare and clubbing of the fingers and toes, a feature not previously described. Five months following surgery, disease spread to the right lung, and atypical lymphomatous transformation occurred in cervical and mediastinal lymph nodes, leading to a superior vena cava syndrome. Chemotherapy with cyclophosphamide and prednisone resulted in significant resolution initially, but ultimately, the patient had progressive axillary node enlargement and succumbed. Clinical and roentgenographic improvement and later deterioration following pneumonectomy and improvement with chemotherapy were mirrored by changes in degree of clubbing, leukocytosis, and elevation of erythrocyte sedimentation rate.