Hi doctor, 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?
Hi. Based on your query and attached images (attachment removed to protect patient identity), my opinion is as follows: FNB. For further information consult a hematologist online.--->