Which of the following is a common presenting symptom in a patient with chronic neutrophilic leukemia (CNL)?

In chronic neutrophilic leukemia (CNL), a common presenting symptom is fever. This condition is characterized by an increase in neutrophil counts, which can lead to various systemic symptoms. Fever can occur due to the underlying disease process, including factors like infection, splenic involvement, or as a direct manifestation of the disease's pathological characteristics.

While fatigue, marked lymphadenopathy, and splenomegaly can also occur in CNL, fever stands out as particularly common. Fatigue is more nonspecific and can occur in many other conditions. Marked lymphadenopathy is generally not typical in CNL, as the disease primarily affects neutrophil production rather than lymphocyte proliferation. Splenomegaly can be present in CNL but is not as universally recognized as a presenting symptom as fever is, given that it may not always be significant enough to be noted upon initial presentation.

Recognizing symptoms like fever is crucial in identifying CNL, as it helps guide healthcare providers toward early diagnosis and management of the disease.