WBC count was 2.46 × 103 μL, hemoglobin was 9.6 g/dL, and platelet count was 133,000 μL. The WBC differential showed 75% neutrophils, 10% lymphocytes, and 5% monocytes. Other laboratory data revealed the following: BUN, 38 mg/dL; creatinine, 1.8 mg/dL; total protein, 5.2 g/dL; albumin, 3.0 g/dL; and IgG, 500 mg/dL. A quantitative Epstein-Barr virus (EBV) DNA test in blood showed 2,000 copies/mL. Fungal serology results for aspergillus, histoplasma, blastomyces, and coccidioides were negative. CT of the chest showed bulky subcarinal adenopathy (Fig 2) and the presence of a 2.2 × 2.8 cm mass lesion in the posterior basal segment of the right lower lobe (Fig 3); CT of the abdomen and pelvis showed a 1.7 × 1.4 cm heterogeneous lesion in the right lobe of the liver and a 1-cm heterogeneous lesion in the left lobe of the liver. CT of the neck was negative for cervical adenopathy.