A 23-Year-Old African American Man Comes to the Emergency Department

A 23-year-old African American man comes to the emergency department due to back and lower extremity pain for 2 days.  He has had several similar episodes over the last 15 years that have required hospitalization.  His pain is not responsive to over-the-counter analgesics, and review of his prior records shows that he has needed treatment with opioids for adequate pain relief.  The patient does not use tobacco, alcohol, or illicit drugs.  On physical examination, he has scleral icterus and tenderness over his lower back and long bones of his thighs.  Laboratory evaluation shows a hemoglobin level of 6.7 g/dL.Histopathologic evaluation of this patient's spleen is most likely to reveal which of the following?

A) Congestion
B) Cyst formation
C) Fibrosis and atrophy
D) Infiltration
E) White pulp hyperplasia

Correct Answer:

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