Question

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.

1. What other questions would be helpful to determine the source of these symptoms?

2. The healthcare provider (HCP) has ordered a chest x-ray because he is suspicious of Hodgkin lymphoma. What is the rationale for this order?

Answer 1

Answer 1: The other questions that can be asked includes if patient has the history of weight loss, loss of appetite, itchy skin, abdominal pain or swelling,cough, shortness of breadth and chest discomfort.

Answer 2: In Hodgkin lymphoma its quite common to have swollen lymph nodes at the center of the chest in area called mediastinum. This helps the physician to make further provisional diagnosisthat will help in future to rule out hodgkin lymphoma. It will also help to rule out if there is an existing pleural effusion.