WBR0005

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Author PageAuthor::Anonymous (Edited by Will Gibson)
Exam Type ExamType::USMLE Step 2 CK
Main Category MainCategory::Internal medicine
Sub Category SubCategory::Oncology, SubCategory::Oncology
Prompt [[Prompt::A 52-year-old man comes to your office with recent issues of fatigue, low-grade fever, anorexia, and pruritus. He states that he can feel small bumps under the skin in his neck and that they seem to become painful when he drinks alcohol. Lab studies show a normal WBC, Hct, Hb, electrolytes, renal function, and glucose. You refer him to a surgeon to obtain a lymph node biopsy, the results of which are pictured below:

What is the most likely diagnosis?]]

Answer A AnswerA::Tuberculosis
Answer A Explanation AnswerAExp::
Answer B AnswerB::Hepatitis
Answer B Explanation AnswerBExp::
Answer C AnswerC::Metastatic cancer
Answer C Explanation AnswerCExp::
Answer D AnswerD::Non Hodgkin's lymphoma
Answer D Explanation AnswerDExp::
Answer E AnswerE::Hodgkin's lymphoma
Answer E Explanation AnswerEExp::
Right Answer RightAnswer::E
Explanation [[Explanation::This patient has many classic signs of lymphoma. Labs are indicative of early disease, and biopsy results indicate conclusively that Hodgkin's lymphoma is present.

Around one to five percent of patients with Hodgkin's disease experience alcohol-related pain; it is a rare but highly specific presentation for Hodgkin's lymphoma.

References: First Aid ___ page __ Bobrove AM (June 1983). "Alcohol-related pain and Hodgkin's disease". The Western Journal of Medicine 138 (6): 874–5.
Educational Objective:
References: ]]

Approved Approved::No
Keyword WBRKeyword::Cancer, WBRKeyword::Hodgkins, WBRKeyword::Lymphoma, WBRKeyword::Leukemia, WBRKeyword::Histology
Linked Question Linked::
Order in Linked Questions LinkedOrder::