An Unusual Cause of Epigastric Pain

A 64-year-old woman was hospitalized because of epigastric pain, back soreness, and poor appetite for 3 months. Herpast and family histories were unremarkable. Physical examination showed epigastric tenderness without rebound pain and rightaxillary lymph node enlargement. Initial laboratory examination showed abnormalities as follows: Leukocyte count, 3.75 10