A 73-year-old woman presented with diffuse abdominal pain of 2-week duration. The patient had immigrated from Algeria 3 years ago and had had no significant medical history prior to presentation. She denied fever, cough, or weight loss, and had not had contact with a person with active tuberculosis. On physical examination, the abdomen was distended and diffusely tender. Chest radiography revealed small pleural effusions bilaterally. Computed tomography of her abdomen showed moderate ascites and multiple small mesenteric lymph nodes.
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