Imaging study. The patient had pleural effusion (A) and severe hepatosplenomegaly (B). Multiple lymph node enlargements were observed in the mesentery and in the paraaortic lymph nodes at admission (arrows in white) (C). After two weekly TCZ infusions, systemic lymphadenopathy, hepatosplenomegaly and renal enlargement improved. However, pleural fluid, ascites and subcutaneous edema worsened (D–F).