Mr. J, aged 38 years, presents to the clinic today for his routine physical. During the review of systems, he offhandedly mentions that he has a “knot” in his neck, but he figures it is no big deal since it does not hurt. He also reports occasional fever and chills, and the last several weeks, he has awakened drenched in sweat. He attributes this to the fact that he was around his niece and nephew who were both recovering from the flu. (Learning Objectives: 4, 13, 14, and 15)
- What other questions would be helpful to determine the source of these symptoms?
- The health care provider (HCP) has ordered a chest x-ray because he is suspicious of Hodgkin lymphoma. What is the rationale for this order?
The health care provider (HCP) tells Mr. J that he would like to biopsy the “knot” in his neck to rule out Hodgkin lymphoma. After the HCP leaves the room, Mr. J immediately starts wringing his hands and says, “Oh my goodness. I know I am going to die. My friend had something like this, and he was dead in 6 months. Who will take care of my family?”
- How will the nurse respond to Mr. J’s concerns?
- What constitutes a definitive diagnosis of Hodgkin lymphoma?
- What are some manifestations associated with non-Hodgkin lymphoma?
- The lymph node biopsy is positive for the Reed-Sternberg cell. What type of treatment is indicated?