I am a 32 year old male. My height is 6 feet and weight is 145 lbs. I am facing a significant unexplained weight loss of more than 45 lbs in four months. My normal weight since high school is 185 to 180 lbs. I am having episodes of significant and frequent drenching night sweats. Also, I have chronic persistent fatigue and occasional non-specific itching. I have a family history of lymphoma with my paternal uncle and maternal cousin. My ultrasound of lymph nodes has two different impressions. The first one was clear bilateral LAD suspicion of neoplastic etiology seen at level 4 and 5. The second opinion was clearly reactive bilateral nodes seen at level 2 and 5. In your opinion, what would be the appropriate course of action? Either FNB or excisional biopsy due to the symptoms and history? Also, if you can interpret films, then I would appreciate your additional opinion. From a differential diagnosis standpoint, what is at the top?
Welcome to icliniq.com.
Based on your query and attached images (attachment removed to protect patient identity), my opinion is as follows:
FNB.Regarding follow up:
For further information consult a hematologist online.---> https://www.icliniq.com/ask-a-doctor-online/hematologist
Thank you doctor,
I will forward this to my hematologist. I also reviewed my blood laboratory reports and realized that my neutrophil count was slightly elevated as well my albumin, alkaline phosphate and LDH. I am not sure if these are clinically relevant. Also, I have noticed a very odd symptom. When I have a glass of wine or beer with dinner the lymph nodes get tender and painful. Otherwise, I do not notice them. I am not sure whether it is a reaction to alcohol.
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For further doubts consult a hematologist online --> https://www.icliniq.com/ask-a-doctor-online/hematologist
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