Ultrasound and Hodgkin's disease of the spleen

A housewife, aged 65, was admitted for investigation of fever and left upper abdominal pain. She had been well until four months previously when she developed a sore throat followed by persistent fever which occurred each day, especially in the evening. The symptoms became worse and she then developed aching in the shoulders and wrists without swelling, and pain in the left upper quadrant of theabdomen, worse on deep inspiration radiating to the left shoulder. She felt ill and had lost 10 kg in weight.