Swollen Lymph Nodes
Case 2
A 22-year-old man comes in because he was shaving and felt a lump on his neck. He states the lump is not painful and he noticed it about 2 weeks ago. He states he’s been more tired than usual for the past month and attributes this to his hectic schedule with work and school. He has not noticed any other changes in his health and denies other symptoms such as fever, weight loss, and difficulty swallowing.
The remainder of his history is as follows:
Past medical and surgical history: tonsillectomy and adenoidectomy; mononucleosis; Medications: none; Allergies: none; Social history: smokes pot two to three times a week and uses no other drugs: drinks four to five beers on weekends; denies tobacco use; business major in college; not in a relationship for the past 6 months.
A complete physical exam was done and is unremarkable except for the presence of a cervical lymph node that is 2 centimeters, rubbery, and fixed. Hodgkin lymphoma is suspected.
Answer the following questions based on this scenario.
- What other clinical manifestations are consistent with Hodgkin lymphoma?
- What are other possible diagnoses to explain these manifestations?
- What diagnostic tests (e.g., CBC) will be done, and what are the expected findings if the diagnosis is Hodgkin lymphoma?
