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A 40-year old male presented with increasing fatigue and weight loss of six months duration. He also reported low grade fever and night sweats for the past four weeks. On examination, multiple enlarged lymph nodes were palpable on both sides of the neck. They varied from 2-3 cms in size and were discrete and non-tender. Abdominal palpation revealed a slight splenic enlargement, but the liver could not be palpated. His temperature was 99.6 degrees Fahrenheit; other vital signs were within normal limits. Examination of peripheral blood revealed total WBC 7000 per cubic millimeter, Hb 9.5 grams per deciliter and platelets of 150,000 per cubic millimeter. WBC differential count was within normal limits. A lymph node biopsy was done. Following the biopsy report, x-rays and CT examination revealed bilateral lymph node enlargements in the mediastinum and the mesenteric regions. The splenic enlargement was confirmed. No lesions could be detected in any visceral organs. He was treated with chemotherapy. The lymph nodes regressed, and he has remained free of symptoms for three years.
- Discuss the clinicopathologic correlation of this case.
- Give your differential diagnosis.
- What is the most likely diagnosis?
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