Chronic lymphocytic leukemia presenting with massive chylous ascites.

A newly diagnosed patient with chronic lymphocytic leukemia who presented with ascites is described. Paracentesis revealed the presence of massive chylous ascites. Further work-up disclosed leukemic infiltration of the liver and bone marrow. Complications leading to his death included renal failure, gastrointestinal hemorrhage, bacterial peritonitis, and Staphylococcus aureus bacteremia. Chylous ascites is a rarely reported manifestation of chronic lymphocytic leukemia. The case is presented, and a review of the literature is discussed.

A note on determinants of inter-metropolitan migration.

The authors "examine empirically the impact on geographic mobility [in the United States] of explicitly including geographic living costs in the migration decision calculus."