A 26yo man has returned from NY to the UK and noticed weight loss, night sweats, temp=37.5C and cervical lymphadenopathy. He also has splenomegaly. What is the dx?
a. TB
b. Lymphoma
c. Bronchial carcinoma
d. Bronchitis
answer: B
Hodgkin lymphoma classically presents as a painless, non-tender, firm, rubbery enlargement of superficial lymph nodes, most often in the cervical region. Splenmegaly (in 50%), B symptoms can cause fever and night sweats.
Epidemiology: Bimodal distribution with peaks in the 20's and >50 yr
Splenomegaly of TB is associated with miliary TB e.g. there would be history of immunosupression.
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