WBR0005

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::