Figure legend:
Figure 1: Non-blanching violaceous rash at initial presentation. Rash
was convalescent on the lower two-thirds of the face (a), and macular
over the trunk (b). Rash resolved completely after the first cycle of
induction chemotherapy. Her family provided consent to publish these
images. Photograph credit: Suhas Radhakrishna.
Figure 2: Diagnostic workup included CT of the neck, chest, abdomen, and
pelvis and PET/CT. CT scan, identified the liver 17 cm in superior to
inferior dimension without focal lesion and spleen 24 cm in superior to
inferior dimension. Spleen was diffusely heterogeneous in attenuation
with several large geographic areas of hypoattenuation. No additional
areas of lymphadenopathy were identified (a). PET/CT was significant for
massive splenomegaly with portions of the spleen intensely
hypermetabolic with Deauville Score 5 (b).