Case 108 – Update 1

Thank you to all the contributions so far!

We have now established that our 32 year old mans neck mass has been gradually increasing in size since he noted it 6 months ago. He has otherwise been well in himself except for feeling more tired. He has no other associated symptoms, no other medical conditions and no significant travel history. He is not on any medications.

His examination reveals unilateral cervical lymphadenopathy (approx 3cm).

An ultrasound demonstrated the mass was indeed a lymph node with disrupted architecture with an uniformly hypo‐echoic enlarged node with the loss of the fatty hilum.

Subsequently histology was obtained by an excision biopsy:

 

Questions:

  1. Any suggestions on the diagnosis? What immunohistochemistry would you request to help?
  2. What further investigations would you perform?

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