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An 83 year old man was referred to the haematology clinic with a three week history of fatigue and shortness of breath on exertion. His symptoms had progressively worsened and on the day of review he felt breathless at rest. He had noted that he bruised easily over his arms and had recently been admitted for recurrent chest infections that required intravenous antibiotics. He had also lost 5 kg in weight during the past month.
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