ABSTRACT
This chapter presents the case study of a 68-year-old woman. A 68-year-old woman presents with a 3-week history of worsening back pain. She has been feeling tired for three months and is also complaining of gradually progressive tongue ‘thickening’. She is otherwise well and has not attended her GP for more than five years. She is on no medication. She is pale and has marked tenderness on palpation of specific areas over her lumbar spine. She has an enlarged tongue, with a smooth papulo-nodular pink infiltrate disrupting the papillae. There is similar involvement of the mucosal aspect of the upper lip extending onto the vermillion lip. Examination of her cardiorespiratory and abdominal systems is normal. She has no palpable lymphadenopathy.
