Twelve year old boy, was admitted at the All India Institute of Medical Sciences, New Delhi in March 1990 with a history of left hypochondrial mass for six years and priapism for 2 days. He had an episode of priapi.~m one month ago, which spontaneously subsided within 8 hours Examination revealed mild pallor, sternal tenderness and gcneralized lymphadcnopathy. The penis was erect, firm, violaccous and tender with superficial venous cngorgment (Figure). Systemic examination revealed splenomegaly of 22 cm and hepatomcgaly of 4 cm. Investigations revealed Hb of 8.2 g/dl, WBC of 460,000/cu.mm., polymorphs 28%, eosinophiLs 1%, basophils 3%, lymphocytes 2%, myelocytes 28%, metamyelocvles 20% and stab forms 18%. Platelet count was 350,000/cu.mm. Serum uric-acid levels were 4.8 mg/dl. Liver function tests, blood urea, electrolytes, calcium and phosphorus levels wcre within normal limits. Skeletal