Case 132 – Update 1!

Thank you for everyone’s contributions regarding our new referral of a 66 year old man with bilateral cervical lymphadenopathy. From your thorough clinical assessments we now the following information:

He first noticed his neck lumps whilst shaving approximately 2 months ago and feels they have gradually increased in size since then. They are not tender.

He has lost approximately half a stone in the last 4 months despite a good appetite. He has not had any night sweats.

He has recurrent respiratory tract infections but has not presented to medical services for these.

He frequently travels to Asia with work and has had the appropriate vaccinations for this.

PMH: type 2 diabetes mellitus (well controlled).

Drug history: Metformin. No recent changes. No over the counter meds.

Social history: Occasional alcohol. Never smoked. No illicit drugs.

Questions:

  1. What are the possible differentials?
  2. What investigations would you request?

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